Prevalence and predictors of abnormal liver enzymes in young women with anorexia nervosa

J Pediatr. 2008 Aug;153(2):247-53. doi: 10.1016/j.jpeds.2008.01.036. Epub 2008 Mar 19.


Objective: To determine the prevalence and predictors of abnormal liver enzyme levels in ambulatory young women with anorexia nervosa (AN).

Study design: In this cross-sectional study of 53 females with AN, serum concentrations of liver enzymes and hormones were measured. Anthropometric, dietary, and body composition information was collected. Correlational analyses were performed between liver enzyme concentrations and these variables.

Results: Elevated alanine aminotransferase (ALT) and gamma-glutamyl transpeptidase (GGT) levels were found in 14 subjects (26%) and 5 subjects (9%), respectively. ALT and GGT were inversely correlated with body mass index (r = -0.27 to -0.30, P < .049) and percentage body fat (r = -0.36 to -0.47, P < .007) but showed no relationship with lean body mass. Subjects with percentage body fat < 18% had higher ALT levels than those above this threshold (median 26.5 vs 18.0 U/L, P = .01). Liver enzyme concentrations did not correlate with dietary variables, except for GGT and percentage of calories from protein (r = 0.28, P = .04).

Conclusions: Serum ALT and GGT concentrations are inversely related to adiposity in young women with AN. Future studies are needed to determine whether these liver enzyme elevations signify unrecognized, clinically relevant liver disease.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Alanine Transaminase / metabolism*
  • Anorexia Nervosa / diagnosis
  • Anorexia Nervosa / enzymology*
  • Anorexia Nervosa / epidemiology*
  • Body Composition
  • Body Mass Index
  • Cross-Sectional Studies
  • Female
  • Humans
  • Insulin Resistance
  • Liver / enzymology*
  • Nutritional Status
  • Predictive Value of Tests
  • Prevalence
  • gamma-Glutamyltransferase / metabolism*


  • gamma-Glutamyltransferase
  • Alanine Transaminase

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