A retrospective analysis of biochemical and haematological parameters in patients with eating disorders

Springer Science and Business Media LLC - Tập 5 - Trang 1-11 - 2017
Leanne J. Barron1,2, Robert F. Barron3, Jeremy C. S. Johnson4, Ingrid Wagner5,6, Cameron J. B. Ward6,7,8,9, Shannon R. B. Ward7, Faye M. Barron10, Warren K. Ward11,12
1Brisbane City Doctors Medical Practice, Brisbane, Australia
2Eating Disorders Multidisciplinary Clinic, Queensland University of Technology, Brisbane, Australia
3Riverina-Murray Institute of Higher Education, Wagga Wagga, Australia
4Royal Brisbane and Women’s Hospital, Brisbane, Australia
5School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
6Lady Cilento Children’s Hospital, Brisbane, Australia
7University of Queensland, Brisbane, Australia
8Mater Medical Research Institute, Brisbane, Australia
9Queensland Paediatric Cardiac Research Group, Queensland, Australia
10Mount Erin College, Wagga Wagga, Australia
11Eating Disorders Service, Royal Brisbane and Women’s Hospital, Brisbane, Australia
12School of Medicine, University of Queensland, Brisbane, Australia

Tóm tắt

The objective of the study was to determine whether levels of biochemical and haematological parameters in patients with eating disorders (EDs) varied from the general population. Whilst dietary restrictions can lead to nutritional deficiencies, specific abnormalities may be relevant to the diagnosis, pathogenesis and treatment of EDs. With ethics approval and informed consent, a retrospective chart audit was conducted of 113 patients with EDs at a general practice in Brisbane, Australia. This was analysed first as a total group (TG) and then in 4 ED subgroups: Anorexia nervosa (AN), Bulimia nervosa (BN), ED Not Otherwise Specified (EDNOS), and AN/BN. Eighteen parameters were assessed at or near first presentation: cholesterol, folate, vitamin B12, magnesium, manganese, zinc, calcium, potassium, urate, sodium, albumin, phosphate, ferritin, vitamin D, white cell count, neutrophils, red cell count and platelets. Results were analysed using IBM SPSS 21 and Microsoft Excel 2013 by two-tailed, one-sample t-tests (TG and 4 subgroups) and chi-square tests (TG only) and compared to the population mean standards. Results for the TG and each subgroup individually were then compared with the known reference interval (RI). For the total sample, t-tests showed significant differences for all parameters (p < 0.05) except cholesterol. Most parameters gave results below population levels, but folate, phosphate, albumin, calcium and vitamin B12 were above. More patients than expected were below the RI for most parameters in the TG and subgroups. At diagnosis, in patients with EDs, there are often significant differences in multiple haematological and biochemical parameters. Early identification of these abnormalities may provide additional avenues of ED treatment through supplementation and dietary guidance, and may be used to reinforce negative impacts on health caused by the ED to the patient, their family and their treatment team (general practitioner, dietitian and mental health professionals). Study data would support routine measurement of a full blood count and electrolytes, phosphate, magnesium, liver function tests, ferritin, vitamin B12, red cell folate, vitamin D, manganese and zinc for all patients at first presentation with an ED.

Tài liệu tham khảo

Marzola E, Nasser JA, Hashim SA, Shih PB, Kaye WH. Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment. BMC Psychiatry. 2013;13:290–303.

Barron LJ, Barron RF, Johnson JCS, Ward SRB, Wagner I, Ward WK. Significant nutritional variables in patients with eating disorders. J Eat Disord. 2015;3(suppl 1):062. Abstract presented to 2015 ANZAED Conference: Riding the Waves to Recovery: Surfers Paradise, Australia. 21-22 August 2015

National Collaborating Centre for Mental Health (UK). Eating disorders: Core interventions in the treatment and Management of Anorexia Nervosa, bulimia nervosa and related eating disorders. Leicester (UK): British Psychological Society 2004; Section 5: Identification.

Rosen DA, the Committee on Adolescence. Identification and Management of Eating Disorders in children and adolescents. Pediatrics. 2010;126:1240–53.

Watson H, Elphick R, Dreher C, Steele A, Wilksch S. Eating disorders prevention, treatment and management: an evidence review. National Eating Disorders Collaboration, for commonwealth dept of ageing: Canberra ACT; March 2010.

Jacobi C, Hayward C, de Zwaan M, Kraemer HC, Agras WS. Coming to terms with risk factors for eating disorders: application of risk terminology and suggestions for a general taxonomy. Psychol Bull. 2004;130(1):19–65.

Cui H, Moore J, Ashiimi SS, Mason BL, Drawbridge JN, Han S, et al. Eating disorder predisposition is associated with ESRRA and HDAC4 mutations. J Clin Invest. 2013;123(11):4706–13.

Scott-Van Zeeland AA, Bloss CS, Tewhey R, Bansal V, Torkamini A, Libiger O, et al. Evidence for the role of EPHX2 gene variants in anorexia nervosa. Mol Psychiatry. 2014;19:724–32.

Klump KL, Culbert KM. Molecular Genetic Studies of Eating Disorders: Current Status and Future Directions. Curr Dir Psychol Sci; 2007, 16:37–41.

Bulik CM. Hot off the Press: The Latest on Genomics and the Intestinal Microbiota in Anorexia Nervosa. Key Note Address, 14th Annual Conference, Australian and New Zealand Academy for Eating Disorders. 26–27 August 2016: Christchurch New Zealand.

Greenblatt JM. Answers to anorexia. A breakthrough nutritional treatment that is saving lives. North Branch.MN: Sunrise River Press; 2010.

Tannhauser PP. Anorexia nervosa: a multifactorial disease of nutritional origin? Int J Adolesc Med Health. 2002;14(3):185–91.

Winston AP. The clinical biochemistry of anorexia. Ann Clin Biochem. 2012;49:132–43.

American Psychiatric Association. Practice guidelines for the treatment of patients with eating disorders. Am J Psychiatry. 2000;157(Suppl 1):1.

Mijan-de-la-Torre A, Mateo-de-Silleras B, Martin-de-la-Torre E, Redondo-del-Rio MP, Perez-Garcia A. Nutrition in Anorexia Nervosa. Module 31.1, Nutrition in Eating Disorders: European Society for Clinical Nutrition (online only) ESPEN LLL Programme; 2008.

Golden NH, Katzman DK, Kneipe RE, Stevens SL, Sawyer SM, Rees J, et al. Eating disorders in adolescents: position paper of the Society for Adolescent Medicine. J of Adolescent Health. 2003;33:496–503.

Rukgauer M, Klein J, Kruse-Jarres JD. Reference values for the trace elements copper, manganese, selenium, and zinc in the serum/plasma of children, adolescents, and adults. J Trace Elem Med Biol. 1997;11(2):92–8.

Miller KK, Grinspoon SK, Ciampa J, Hier J, Herzog D, Klibanski A. Medical findings in outpatients with anorexia nervosa. Arch Intern Med. 2005;165(5):561–6.

Beumont P, Hay P, Beumont D, Birmingham L, Denham H, Jordan A, et al. Australian and New Zealand clinical practice guidelines for the treatment of AN. Aust NZ J Psychiatry. 2004;38:659–70.

Thornton C, Touyz S, Buckingham C. L. eating disorders: management in general practice. Medicine Today. 2005;6(10):29–36.

Birmingham CI, Beumont P. Medical Management of Eating Disorders. Cambridge: Cambridge University Press; 2004.

Fisher M, Golden NH, Katzman DK, Kneipe RE, Rees J, Schebendach J, et al. Eating disorders in adolescents: a background paper. J Adolesc Health. 1995;16(6):420–37.

Sim LA, McAlpine DE, Grothe KB, Himes SM, Cockerill RG, Clark MM. Identification and treatment of eating disorders in the primary care setting. Mayo Clin Proc. 2010;85(8):746–51.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington DC: DSM-IV; 1994.

Wright EM, Royston P. Calculating reference intervals for laboratory measurements. Stat Methods Med Res. 1999;8(2):93–112.

National Association of Testing Authorities. Application document: supplementary requirements for accreditation in the field of medical testing (AS4633, ISO 15189). Rhodes, Australia: NATA; 2007.

Tate JR, Sikaris KA, Jones GRD, Yen T, Koerbin G, Ryan J, et al. Harmonising adult and Paediatric reference intervals in Australia and New Zealand: an evidence-based approach for establishing a first panel of chemistry Analytes. Clin Biochem Rev. 2014;35(4):213–28.

Koerbin G, Cavanaugh JA, Potter JM, Abhayaratna WP, West NP, Glascow N, et al. Aussie Normals: an a priori study to develop clinical chemistry reference intervals in a healthy Australian population. Pathology. 2015;47(2):138–44.

Sullivan-Nicolaides Pathology, Member of sonic healthcare group, Taringa, Queensland, Australia; 2007.

Ison C, Sullivan-Nicolaides pathology: personal correspondence to Dr R. Barron, 19 October 2015.

Australian Bureau of Statistics. Australian Aborigine and Torres Strait Islander Health Survey 2012–13. Canberra: ABS; 2007.

Abbott Ireland Diagnostics Division. Architect System, Vitamin B12. Longford, Ireland; 2013.

Haglin L. Hypophosphataemia in anorexia nervosa. Postgrad Med J. 2001;77:305–11.

Hoskins RG. The manganese treatment of schizophrenia disorders. J Nervous Mental Disorders. 1934;79:59.

Underwood EJ. Trace Elements in Human and Animal Nutrition: Manganese. NY Academy Press 1977; 170–95.

Keen CL, Ensunsa JL, Watson MH, Baly DL, Donovan SM, Manaco MH, et al. Nutritional aspects of manganese from experimental studies. Neurotoxicology. 1999;20(2–3):213–23. (PubMed)

Dillan J. How Manganese Deficiency Impacts Enzyme Production. http://www.healthambition.com/manganese-deficiency. Accessed 23 Dec 2013. Accessed 20 June 2017.

Wickham, E. The Symptoms of Manganese Deficiency. http://www.livestrong.com. Accessed 20 June 2017.

Watts D. Trace Elements in Human and Animal Nutrition: Clinical Applications of Tissue Mineral Analysis. 5th Ed; USA: 2006.

Mergler D. Neurotoxic effects of low level exposure to manganese in human populations. Environ Res. 1999;80:99–102.

WHO. Trace elements in human nutrition and health: manganese. Geneva: World Health Organization; 1996. p. 163–7.

Birmingham CL, Goldner EM, Bakan R. Controlled trial of zinc supplementation in anorexia nervosa. Int J of Eat Disord. 1994;15(3):251–5.

Osiecki H. Nutritional bible. 9th ed. Eagle Farm Qld: Bio Concepts Publishing; 2010.

Markiewicz-Zukowska R, Gutowska A, Borawska MH. Serum zinc concentrations correlate with mental and physical status of nursing home residents. PLoS One. 2015;10(1):e0117257.

Takeda E, Taketani Y, Sawada N, Sato T, Yamamoto H. The regulation and function of phosphate in the human body. Biofactors. 2004;21(1–4):345–55.

Jahnen-Dechent W, Ketteler M. Magnesium Basics. Clun Kidney J. 2012;5(Suppl 1):13–4.

National Health and Medical Research Council. Nutritional reference values of Australia and New Zealand; magnesium. Canberra: Ministry of Health; 2014.

Kirov GK, Birch NJ, Steadman P, Ramsey RG. Plasma magnesium levels in a population of psychiatric patients: correlation with symptoms. Neuropsychbiology. 1994;30(2–3):73–8.

Birmingham CL, Treasure J. Medical Management of Eating Disorders. 2nd ed. Cambridge UK: University Press; 2010.

Kushner I. The phenomenon of acute phase response. Annals of NY Academy of Sc. 2016;389:39–48.

Wang W, Knovich MA, Coffman LG, Torti FM, Torti SV. Serum Ferritin: Past. Present and Future Biochim Biophys Acta. 2010;1800(8):760–9.

Rigaud D, Tallonneau I, Verges B. Hypercholesterolaemia in anorexia nervosa: frequency and changes during refeeeding. Diabetes Metab. 2009;35:57–63.

Ohwada R, Hotta M, Oikawa S, Takano K. Etiology of hypercholesterolemia in patients with anorexia nervosa. Int J Eat Disord. 2006;39:598–601.

Campbell-McBride N. Cholesterol: friend or foe? In: wise traditions in food, farming and the healing arts. Washington DC: Weston A. Price Foundation; 2007.

Salamon M. Can total cholesterol levels be too low? http://cholesterol.about.com/lw/Health-Medicine/Conditions-and-diseases.Accessed 4 Nov 2013 and 20 June 2017.

Sheehan W, Steiner RD, Thurber SD, Du Souich C. Aberrant cholesterol and lipoprotein levels in aggressive male adolescents. WebmetCentral, Psychiatry. 2011;2(10):WMC002346.

Kaplan A. Statins, cholesterol depletion-and mood disorders: What’s the link? Psychiatric Times. 2010;27:11.

Favaro A, Caregaro L, et al. Total serum cholesterol and Suicidality in anorexia nervosa. Psychosom Med. 2004;66:548–52.

Friedman BJ, Freeland-Graves JH, Bales CW, et al. Manganese balance and clinical observations in young men fed a manganese-deficient diel. J Nutr. 1987;117(1):133–43.

AIHW. Monitoring the health impacts of mandatory folic acid and iodine fortification 2016. Canberra: AIHW; 2016.

Division of Laboratory Sciences. Second National Report on biochemical indicators of diet and nutrition in the US population. Atlanta Ga; National Centre for Environmental Health: 2012.

http://gbhealthwatch.com/Nutrient-Folate-Overview.php.2013.

Robins B. Folic Acid: Too much of a good thing can be bad. 2012. http://insidetracker.com/blog/post/164664709616. Accessed 23 June 2015.

Autier P, Bonid M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. The Lancet Diabetes and Endocrinology J. 2014;2(1):76–89.

Tidy C. Vitamin D Deficiency including Osteomalacia and Rickets. http://patient.info/doctor/vitamin-d-deficiency-including-ostemalacia-and-rickets-pro. Accessed 29 June 2015 and 20 June 2017.

Modan-Moses D, Levy-Shraga Y, Pinkas-Hamiel O, Kochavi B, Enoch-Levy A, Vered I, et al. High prevalence of vitamin D deficiency and insufficiency in adolescent inpatients diagnosed with eating disorders. Int J of Eat Disord. 2015;48:607–14.

Facchini M, Sala L, Malfatto G, Bragato R, Redaelli G, Invitti C. Low-K+ dependent QT prolongation and risk for ventricular arrhythmia in anorexia nervosa. Int J Cardiology. 2005;01:041.

Sachs KV, Harnke B, Mehler PS, Krantz MJ. Cardiovascular complications of anorexia nervosa: a systemic review. Int J Eat Dis. 2016;49(3):238–48.

LaValle JB. Your blood never lies. NY: Square One Publishers; 2013.

Kaysen GA. Serum albumin concentration in dialysis patients: why does it remain resistant to therapy? Kidney Int. 2003;87:S92–8.

de Oliveira EP, Burini RC. High plasma uric acid concentration: causes and consequences. Diabetology and Metabolic Syndrome. 2012:4–12.

Thông tin
Thông tin xuất bản

Springer Science and Business Media LLC

Tập 5

1-11

Thông tin tác giả