Increased lipid and lipoprotein concentrations in anorexia nervosa: A systematic review and meta‐analysis

Hussain, Alia Arif; Hübel, Christopher; Hindborg, Mathias; Lindkvist, Emilie Bundgaard; Kastrup, Annie M.; Yılmaz, Zeynep; Støving, René Klinkby; Bulik, Cynthia M.; Sjögren, Jan Magnus

doi:10.1002/eat.23051

Cited by 44 publications

(47 citation statements)

References 75 publications

(148 reference statements)

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“…The data extraction sheet was based on two previous meta‐analyses (Hussain et al, ; Ilyas et al, ) and included variables that were hypothesized to be associated with body composition, hormonal, or metabolic measures, including fasting status and period, medications, stage of the menstrual cycle, or treatments for longitudinal studies. If enough studies reported these variables, we performed meta‐regressions to investigate their associations with our primary and secondary outcomes.…”

Section: Methodsmentioning

confidence: 99%

“…Anorexia nervosa (AN) has one of the highest mortality rates of all psychiatric disorders (Chesney, Goodwin, & Fazel, ). Clinical observations show altered body composition (El Ghoch, Calugi, Lamburghini, & Dalle Grave, ; Solmi et al, ) accompanied by elevated cholesterol (Hussain et al, ) and greater insulin sensitivity (Ilyas et al, ). However, conclusions are limited by small sample sizes and consequent mixed findings.…”

Section: Introductionmentioning

confidence: 99%

“…BIA, binge-eating/purging, bioelectrical impedance analysis, body fat percentage, bone, dualenergy X-ray absorptiometry, DXA, estradiol, fat-free mass, insulin, lean mass, long-term followup, restricting, thyroid, weight restoration 1 | INTRODUCTION Anorexia nervosa (AN) has one of the highest mortality rates of all psychiatric disorders (Chesney, Goodwin, & Fazel, 2014). Clinical observations show altered body composition (El Ghoch, Calugi, Lamburghini, & Dalle Grave, 2014;Solmi et al, 2016) accompanied by elevated cholesterol (Hussain et al, 2019) and greater insulin sensitivity (Ilyas et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Body composition in anorexia nervosa: Meta‐analysis and meta‐regression of cross‐sectional and longitudinal studies

Hübel

Yılmaz

Schaumberg

et al. 2019

Intl J Eating Disorders

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Objective Clinically, anorexia nervosa (AN) presents with altered body composition. We quantified these alterations and evaluated their relationships with metabolites and hormones in patients with AN longitudinally. Method In accordance with PRISMA guidelines, we conducted 94 meta‐analyses on 62 samples published during 1996–2019, comparing up to 2,319 pretreatment, posttreatment, and weight‐recovered female patients with AN with up to 1,879 controls. Primary outcomes were fat mass, fat‐free mass, body fat percentage, and their regional distribution. Secondary outcomes were bone mineral density, metabolites, and hormones. Meta‐regressions examined relationships among those measures and moderators. Results Pretreatment female patients with AN evidenced 50% lower fat mass (mean difference [MD]: −8.80 kg, 95% CI: −9.81, −7.79, Q = 1.01 × 10−63) and 4.98 kg (95% CI: −5.85, −4.12, Q = 1.99 × 10−28) lower fat‐free mass, with fat mass preferentially stored in the trunk region during early weight restoration (4.2%, 95% CI: −2.1, −6.2, Q = 2.30 × 10−4). While the majority of traits returned to levels seen in healthy controls after weight restoration, fat‐free mass (MD: −1.27 kg, 95% CI: −1.79, −0.75, Q = 5.49 × 10−6) and bone mineral density (MD: −0.10 kg, 95% CI: −0.18, −0.03, Q = 0.01) remained significantly altered. Discussion Body composition is markedly altered in AN, warranting research into these phenotypes as clinical risk or relapse predictors. Notably, the long‐term altered levels of fat‐free mass and bone mineral density suggest that these parameters should be investigated as potential AN trait markers. ResumenObjetivo Clínicamente, la anorexia nervosa (AN) se presenta con alteraciones en la composición corporal. Cuantificamos estas alteraciones y evaluamos longitudinalmente su relación con metabolitos y hormonas en pacientes con AN. Método De acuerdo con las pautas PRISMA, realizamos 94 meta‐análisis en 62 muestras publicadas entre 1996–2019, comparando hasta 2,319 pacientes mujeres en pre‐tratamiento, post‐tratamiento, y recuperadas en base al peso con hasta 1,879 controles. Las principales medidas fueron masa grasa, masa libre de grasa, porcentaje de grasa corporal y su distribución regional. Las medidas secundarias fueron densidad mineral ósea, metabolitos y hormonas. Las meta‐regresiones examinaron las relaciones entre esas medidas y moderadores. Resultados Las pacientes femeninas con AN pre‐tratamiento mostraron un 50% menos de masa grasa (MD: −8.80 kg, CI 95%: −9.81, −7.79, Q = 1.01 × 10–63) y 4.98 kg (CI 95%: −5.85, −4.12, Q = 1.99 × 10–28) menos de masa libre de grasa, con masa grasa preferentemente almacenada en la región del tronco durante la recuperación temprana del peso (4.2%, CI 95%: −2.1, −6.2, Q = 2.30 × 10–4). Aunque la mayoría de los rasgos regresaron a los niveles vistos en los controles sanos después de la restauración del peso, la masa libre de grasa (MD: −1.27 kg, CI 95%: −1.79, −0.75, Q = 5.49 × 10–6) y la densidad mineral ósea (MD: −0.10 kg, CI 95%: −0.18, −0.03, Q = 0.01) perm...

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body composition in anorexia nervosa: Meta‐analysis and meta‐regression of cross‐sectional and longitudinal studies

Hübel

Yılmaz

Schaumberg

et al. 2019

Intl J Eating Disorders

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“…Very low-density lipoproteins transport endogenous produced lipids from the liver to peripheral tissues. A meta-analysis observed no association between very low-density lipoprotein and anorexia nervosa in acutely ill patients [14]. However, only three studies with 90 anorexia nervosa cases were included to obtain the pooled estimate and heterogeneity was high.…”

Section: Discussionmentioning

confidence: 99%

Associations between Blood Metabolic Profile at 7 Years Old and Eating Disorders in Adolescence: Findings from the Avon Longitudinal Study of Parents and Children

et al. 2019

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Eating disorders are severe illnesses characterized by both psychiatric and metabolic factors. We explored the prospective role of metabolic risk in eating disorders in a UK cohort (n = 2929 participants), measuring 158 metabolic traits in non-fasting EDTA-plasma by nuclear magnetic resonance. We associated metabolic markers at 7 years (exposure) with risk for anorexia nervosa and binge-eating disorder (outcomes) at 14, 16, and 18 years using logistic regression adjusted for maternal education, child’s sex, age, body mass index, and calorie intake at 7 years. Elevated very low-density lipoproteins, triglycerides, apolipoprotein-B/A, and monounsaturated fatty acids ratio were associated with lower odds of anorexia nervosa at age 18, while elevated high-density lipoproteins, docosahexaenoic acid and polyunsaturated fatty acids ratio, and fatty acid unsaturation were associated with higher risk for anorexia nervosa at 18 years. Elevated linoleic acid and n-6 fatty acid ratios were associated with lower odds of binge-eating disorder at 16 years, while elevated saturated fatty acid ratio was associated with higher odds of binge-eating disorder. Most associations had large confidence intervals and showed, for anorexia nervosa, different directions across time points. Overall, our results show some evidence for a role of metabolic factors in eating disorders development in adolescence.

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“…Нервная анорексия. В одном из систематических обзоров и мета-анализе литературы были проиллюстрированы изменения липидного профиля у пациентов с нервной анорексией в виде повышения концентрации ОХ, ЛВП, ЛНП и триглицеридов [12]. Предполагают, что при нервной анорексии может развиваться повышенное всасывание жиров кишечником вследствие изменений в микробиоте, о чем свидетельствуют более высокие концентрации фитостеролов, в частности кампестерола и бета-ситостерола, у пациентов с нервной анорексией [13].…”

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Secondary hyperlipidemias: etiology and pathogenesis

et al. 2019

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В соответствии с современными клиническими рекомендациями основной целью терапии для снижения сердечно-сосудистого риска является достижение целевого уровня липидных показателей. Целый ряд заболеваний, с которыми пациенты ежедневно обращаются к врачу, лекарственные препараты, назначаемые в рутинной клинической практике, а также нарушения в диете способны вызывать развитие нарушений липидного обмена, называемых вторичными гиперлипидемиями. Выявление и лечение (или устранение) вторичных причин гиперлипидемий может способствовать повышению эффективности лечения больных с нарушениями липидного обмена. В данном обзоре представлены основные состояния и патогенетические механизмы, обусловливающие развитие вторичных гиперлипидемий.

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Increased lipid and lipoprotein concentrations in anorexia nervosa: A systematic review and meta‐analysis

Cited by 44 publications

References 75 publications

Body composition in anorexia nervosa: Meta‐analysis and meta‐regression of cross‐sectional and longitudinal studies

Body composition in anorexia nervosa: Meta‐analysis and meta‐regression of cross‐sectional and longitudinal studies

Associations between Blood Metabolic Profile at 7 Years Old and Eating Disorders in Adolescence: Findings from the Avon Longitudinal Study of Parents and Children

Secondary hyperlipidemias: etiology and pathogenesis

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