[Nutritional status and immunocompetence in bulimia]

Abstract

Due to the fact that malnutrition gives rise to a decrease in immunocompetence and that this parameter is used in turn to assess the patient's nutritional state, certain aspects of cell-mediated immunity were studied in a group of female patients suffering from atypical malnutrition (bulimia nervosa) and compared with those of healthy young female controls in order to establish their nutritional condition. Several anthropometric and hematological parameters were determined in the patient and healthy groups: weight, height, body mass index (BMI), WBC, blood lymphocyte count, lymphocyte subsets: T11 (CD2), B1 (CD20), T4 (CD4) and T8 (CD8) (through flow cytometry). The BMI of the bulimic group was 15.8 +/- 0.52 (placing these patients within the "low weight" range), 27% weight than control subjects. WBC counts were significantly lower in the bulimic group. However, the peripheral blood lymphocyte/mm3 count did not change, while the percentage values were higher than the control ones. CD2 and CD4 lymphocyte percentages were lower in the bulimic group, the CD20 percentage was higher and the CD8 subset did not change. The CD4/CD8 rate (main immunologic index in evaluating the patient's nutritive condition) was significantly lower in the patient population (0.80 +/- 0.10) than in the control group (1.87 +/- 0.14). The conclusion was that the bulimic patients studied could suffer from severe malnutrition, as reflected from the anthropometric measurements and from the immunocompetent system dysfunction, which do not seem to follow lymphocyte subset changes in typical malnutrition cases.