Cholesterol metabolism in anorexia nervosa and hypercholesterolemia

Abstract

Fecal bile acid and neutral sterol excretion were measured in 4 girls with anorexia nervosa using the chemical sterol balance technique. Bile acid excretion was markedly reduced in 12 (30 and 65 mg/day) in whom the plasma cholesterol concentrations were respectively 410 and 370 mg/100 ml. In the 2 other girls whose plasma cholesterol concentrations were 230 and 265 mg/100 ml daily bile acid outputs were 197 mg and 100 mg (normal range). In the 3 girls with hypercholesterolemia, the daily intake of cholesterol exceeded the total fecal excretion of steroids, indicating that dietary cholesterol was being retained. One subject was restudied when she had regained lost weight. Her plasma cholesterol had fallen from 410 to 225 mg/100 ml, bile acid excretion had risen from 30 to 153 mg/day and the sterol balance had changed from a retention of 189 mg to a net excretion of 655 mg/day. Hypercholesterolemia in anorexia nervosa may reflect diminished cholesterol and bile acid turnover which may result from reduced caloric intake. © 1974 by The Endocrine Society.