Metabolic abnormalities in adolescent patients with anorexia nervosa

Milner, Mark R.; McAnarney, Elizabeth R.; Klish, William J.

doi:10.1016/s0197-0070(85)80016-4

Cited by 30 publications

(28 citation statements)

References 20 publications

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“…The most notable exception is anorexia nervosa, in which TC and HDL-C rise and TG falls (19,20). In both of these conditions, the lipoprotein profiles are markedly different from that 'found in untreated SLE.…”

Section: Discussionmentioning

confidence: 87%

Dyslipoproteinemia in pediatric systemic lupus erythematosus

Ilowite

Samuel

Ginzler

et al. 1988

Arthritis & Rheumatism

141

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Patients with systemic lupus erythematosus are at increased risk for premature atherosclerosis. We examined one possible etiologic factor, dyslipoproteinemia, both before and after corticosteroid therapy. We identified 2 distinct patterns of dyslipoproteinemia. One is attributable to active disease; the other is attributable, in part, to corticosteroid therapy. The dyslipoproteinemia of active disease consists of depressed high density lipoprotein cholesterol and apoprotein A-I with elevated very low density lipoprotein cholesterol and triglyceride, while the dyslipoproteinemia after corticosteroid therapy consists of increased total cholesterol, very low density lipoprotein cholesterol, and triglyceride. The possible pathophysiologic mechanisms responsible for these patterns, as well as the possible roles in premature atherosclerosis seen in systemic lupus erythematosus patients, are discussed.Premature atherosclerosis and its sequelae, myocardial infarction and cerebrovascular accident, have recently been recognized as complications of systemic lupus erythematosus (SLE) (1-7). Possible etiologies include dyslipoproteinemia, vasculitis, hypertension, and increased tendency for thrombosis associated with the presence of circulating anticoagulant (1-8).Dyslipoproteinemia is common in adult SLE patients (9); however, the relationships of disease activity, diet, corticosteroid therapy, and concurrent renal, liver, and pancreatic disease have not been studied well. To differentiate the roles of corticosteroids and disease activity in the dyslipoproteinemia of SLE, we studied newly diagnosed pediatric patients both before and after high-dose systemic prednisone therapy. PATIENTS AND METHODSPatients. Ten successive pediatric patients (younger than 21 years of age) newly diagnosed as having SLE were enrolled after informed consent was obtained. Nine fulfilled the requirements of the American Rheumatism Association revised diagnostic criteria (10). The other (patient 5) had anticardiolipin, high-titer speckled antinuclear, anti-Smith, and anti-double-stranded DNA antibodies, circulating lupus anticoagulant, hypocomplementemia, and recurrent pulmonary emboli. He was not treated with corticosteroids. Eight patients underwent percutaneous renal biopsy prior to therapy. Results are shown in Table 1. In all 10 patients at diagnosis, and in 8 patients at 4-8 weeks after institution of 1-2 mg/kg/day of prednisone, fasting plasma lipid profiles (see below) were obtained. Dietary intake was quantified by 3-day diet record, and this was supplemented with 24-hour recall

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Section: Discussionmentioning

confidence: 87%

Dyslipoproteinemia in pediatric systemic lupus erythematosus

Ilowite

Samuel

Ginzler

et al. 1988

Arthritis & Rheumatism

141

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“…11,12 The aim of our study was to describe the prevalence of disturbances of liver function tests, to search for possible predictors of occurrence of these disturbances and finally to observe their evolution over gradual refeeding by enteral nutrition in a cohort of severely malnourished AN patients. We identified four risk factors for occurrence of hepatic cytolysis: age below 30, BMI below 12, male sex and the pure restrictive form of the disease (ANR).…”

Section: Discussionmentioning

confidence: 99%

Hypertransaminasemia in severely malnourished adult anorexia nervosa patients: Risk factors and evolution under enteral nutrition

2013

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“…Thus, we started a prospective study to clarify the clinical implication of serum aminotransferase elevation in anorexia nervosa. To date, numerous studies have discussed the elevation of serum aminotransferase levels in the patients with anorexia nervosa (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). However, there have been no consistent patterns in the results and the clinical implication has not been clarified (2).…”

Section: Introductionmentioning

confidence: 99%

Elevation of Serum Aminotransferase as a Sign of Multiorgan-Disorders in Severely Emaciated Anorexia Nervosa.

1998

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To clarify the clinical significance of elevation of serum aminotransferase levels in anorexia nervosa, we analyzed the relationships of serum aminotransferase levels to other serum biochemistry and physical conditions before and during refeeding therapy in 101 patients with anorexia nervosa. Before refeeding therapy, body mass index (BMI) was distributed from 9.9 to 16.4 kg/m2 (13.2 ± 1.3, mean ± SD), and 29 patients (28.7 % ) showed abnormally high aminotransferase levels. Among17 patients with a BMIof less than 12 kg/m2, the aminotransferase level was abnormally high in 13 patients (76 % ). Incidence and severity of serum aminotransferase elevation were greater in the patients with lower BMI. The groups with high serum aminotransferase levels had a lower body temperature, lower pulse rate, and higher incidence of other biochemical abnormalities than the group with normal serum aminotransferase levels. These findings indicate that aminotransferase elevation develops at a high incidence in anorectic patients with a critically life-threatening condition, and it is a sign of multiorgan failure requiring urgent calorie repletion. This type of aminotransferase elevation is to be distinguished from refeeding-induced aminotransferase elevation.

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Metabolic abnormalities in adolescent patients with anorexia nervosa

Cited by 30 publications

References 20 publications

Dyslipoproteinemia in pediatric systemic lupus erythematosus

Dyslipoproteinemia in pediatric systemic lupus erythematosus

Hypertransaminasemia in severely malnourished adult anorexia nervosa patients: Risk factors and evolution under enteral nutrition

Elevation of Serum Aminotransferase as a Sign of Multiorgan-Disorders in Severely Emaciated Anorexia Nervosa.

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