Carbonyl stress markers are associated with binge-eating/purging behavior of anorexia nervosa: A pilot study

Anorexia nervosa (AN) is a severe psychiatric disorder causing life-threatening physical conditions. Management strategies differ between the restricting subtype (ANR) and the binge-eating/purging subtype (ANBP), with underreported binge-eating/purging behaviors. Objective biomarkers are needed to detect these behaviors for improved treatment. This study explored fingertip autofluorescence (FAF) Advanced Glycation End Products (AGEs), reflecting carbonyl stress, to assess their potential in reflecting binge-eating/purging behavior in AN.

This cross-sectional study involved 26 female patients with AN and 27 healthy control (HC) participants. Participants completed the Eating Disorder Examination Questionnaire 6.0 (EDE-Q 6.0) and underwent percutaneous fluorescence measurement of AGE levels. Statistical analysis included one-way anova with Tukey's Honestly Significant Difference (HSD) test, Pearson correlation, and multiple linear regression to determine if EDE-Q items predicted fingertip AGE levels in patients with ANBP.

Fingertip AGE levels and all EDE-Q 6.0 subscale scores significantly differed among groups (p < 0.05). Post hoc analyses indicated that participants with ANBP had significantly higher fingertip AGE levels than those with ANR. Correlation analysis showed that the frequency of binge-eating and vomiting significantly positively correlated with fingertip AGE levels. Stepwise regression analysis suggested that the frequency of vomiting significantly predicted fingertip AGE levels.

Fingertip AGE levels were higher in patients with ANBP than in those with ANR. Purging behavior, which was significantly correlated with binge-eating behavior in the ANBP group, was suggested to be a primary determinant of elevated AGE levels. Fingertip AGE levels may serve as objective biomarkers for detecting these behaviors and facilitating improved treatment strategies.