Recent studies have shown elevated homocysteine levels in patients with eating disorders. In a prospective, longitudinal study, we investigated differences of homocysteine plasma levels in patients with anorexia nervosa (N = 12) and bulimia nervosa (N = 17) compared to healthy controls (N = 20) and alteration of homocysteine levels in patients during specific in-patient treatment. We found significantly elevated homocysteine levels in both patient groups (anorexia nervosa and bulimia nervosa) and a non-significant decrease of homocysteine during the 12-week treatment period. Furthermore, we found a significant association between low homocysteine levels and cognitive deficits, pointing toward a beneficial effect of elevated homocysteine levels on cognition in this patient group. We suppose that during effective treatment with significant increase of the body mass index, the observed hyperhomocysteinemia in patients with eating disorders is partially reversible. These findings add further evidence to the hypothesis that homocysteine might be involved in the pathophysiology of anorexia and bulimia nervosa.
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