Associations of Elevated Liver Enzymes among Hospitalized Adolescents with Anorexia Nervosa

Park, K.T.; Colditz, Kelley; Golden, Neville H.

doi:10.1016/j.jpeds.2014.10.048

Cited by 41 publications

(37 citation statements)

References 25 publications

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“…Multivariate analysis using logistic regression was performed with the presence of elevated ALT levels during refeeding as the dependent variable. The independent variables included BMI on admission, initial prescribed calories (which was considered clinically important in a previous report) [10], and factors identified by univariate analysis. Values of p < 0.05 were considered statistically significant.…”

Section: Methodsmentioning

confidence: 99%

“…Progression of refeeding may worsen liver injury, but there is evidence that faster weight gain predicts year 1 weight recovery [17]. To our knowledge, the only published data related to this problem show that the initial prescribed caloric intake may be associated with elevated liver enzymes during refeeding [10]. Little remains known about the causes and optimal management of elevated liver enzymes in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study

et al. 2016

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BackgroundThere are few previous reports regarding the cause and evolution of liver injury in patients with anorexia nervosa (AN) during the refeeding process, and its management remains controversial. This study aimed to determine the risk factors for elevated liver enzymes during refeeding and their effect on the therapeutic process in severely malnourished patients with eating disorders.MethodsIn a retrospective cohort study of 167 female inpatients in a single hospital from January 2004 to March 2015, 67 who had normal alanine aminotransferase (ALT) levels on admission were divided into two groups according to the presence or absence of elevated ALT levels during refeeding, and then compared.ResultsThe median age and body mass index (BMI) of the patients on admission were 22 [interquartile range (IQR), 16–33] years and 12.2 (IQR, 11.1–13.0) kg/m2, respectively. Compared with their cohorts, significantly more patients in the early onset age group (<15 years old) had elevated ALT levels during refeeding (67% vs. 33%, p = 0.033), as did patients with longer median time to nadir BMI (3.0 vs. 0 days, p = 0.03). In addition, onset age [odds ratio (OR): 0.274; 95% confidence interval (CI): 0.077–0.981; p = 0.047] and time to nadir BMI (OR: 1.271; 95% CI: 1.035–1.56; p = 0.022) were significantly associated with the odds of elevated ALT levels during refeeding.ConclusionsThe results of this study suggest that early age at onset may be a potential risk factor for elevated ALT levels during refeeding in severely malnourished patients with eating disorders. Furthermore, elevated ALT levels during refeeding were significantly associated with delay in the start of weight gain. No significant relationship was found between the amount of initial prescribed calories and elevated ALT levels during refeeding. The median time to maximum ALT was 27 (IQR, 21–38) days after the refeeding process started.Electronic supplementary materialThe online version of this article (doi:10.1186/s40337-016-0127-x) contains supplementary material, which is available to authorized users.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study

et al. 2016

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“…Sendo o fígado, órgão central do metabolismo, quase sempre afetado (COUTO et al, 2008), consequentemente visualiza-se um aumento da atividade das enzimas hepáticas FA, ALT e AST possivelmente decorrente da morte celular de hepatócitos (COUTO et al, 2008;NAGATA et al, 2015).…”

Section: Introductionunclassified

“…A perda energético-proteica leva à deterioração das funções hepáticas com aumento de ALT, AST e FA (CHOWDHURY et al, 2007;COUTO et al, 2008;NAGATA et al, 2015). Estudo realizado por NAGATA et al (2015) em pacientes humanos com anorexia nervosa demonstrou que a perda de massa muscular e gordura corporal promoveu o aumento da ALT e AST devido a hipóxia hepática e a diminuição da pressão portal.…”

Section: Introductionunclassified

“…Estudo realizado por NAGATA et al (2015) em pacientes humanos com anorexia nervosa demonstrou que a perda de massa muscular e gordura corporal promoveu o aumento da ALT e AST devido a hipóxia hepática e a diminuição da pressão portal. Em estudo com crianças desnutridas, realizado por CHOWDHURY et al (2007), também foi observado valores acima da normalidade para estas enzimas hepáticas, sendo tal fato correlacionado com a desnutrição.…”

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Alterações Laboratoriais E Imaginológicas Associadas Ao Quadro De Desnutrição Secundária À Insuficiência Pancreática Exócrina Em Cães: Relato De Dois Casos

Porsani¹,

Paludetti²,

Lima³

et al. 2015

Enciclopédia Biosfera

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Gastrointestinal complications associated with anorexia nervosa: A systematic review

Norris

Harrison

Isserlin

et al. 2015

Intl J Eating Disorders

122

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Associations of Elevated Liver Enzymes among Hospitalized Adolescents with Anorexia Nervosa

Cited by 41 publications

References 25 publications

Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study

Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study

Alterações Laboratoriais E Imaginológicas Associadas Ao Quadro De Desnutrição Secundária À Insuficiência Pancreática Exócrina Em Cães: Relato De Dois Casos

Gastrointestinal complications associated with anorexia nervosa: A systematic review

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