<scp>V</scp>itamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa

Giollo, Alessandro; Idolazzi, Luca; Caimmi, Cristian; Fassio, Angelo; Bertoldo, Francesco; Grave, Riccardo Dalle; Ghoch, Marwan El; Calugi, Simona; Bazzani, Paola Vittoria; Viapiana, Ombretta; Rossini, Maurizio; Gatti, Davide

doi:10.1002/eat.22731

Cited by 25 publications

(14 citation statements)

References 39 publications

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“…[47] Despite severe malnutrition, the bioavailability of oral ergocalciferol in young AN patients was similar to that of healthy controls [48]. Vitamin D deficiency can contribute to bone mineral density loss, which is the most frequent chronic complication of AN disease [49]. The supplementation of vitamin D should be provided to all AN malnourished patients [46].…”

Section: Discussionmentioning

confidence: 99%

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

et al. 2019

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Introduction: Anorexia nervosa (AN) is a complex psychiatric disorder, which can lead to specific somatic complications. Undernutrition is a major diagnostic criteria of AN and it can be associated with several micronutrients deficiencies. Objectives: This study aimed to determinate the prevalence of micronutrients deficiencies and to compare the differences between the two subtypes of AN (restricting type (AN-R) and binge-eating/purging type (AN-BP)). Methods: We report a large retrospective, monocentric study of patients that were hospitalized in a highly specialized AN inpatient unit between January 2011 and August 2017 for severe malnutrition treatment in the context of anorexia nervosa. Results: Three hundred and seventy-four patients were included, at inclusion, with a mean Body Mass Index (BMI) of 12.5 ± 1.7 kg/m2. Zinc had the highest deficiency prevalence 64.3%, followed by vitamin D (54.2%), copper (37.1%), selenium (20.5%), vitamin B1 (15%), vitamin B12 (4.7%), and vitamin B9 (8.9%). Patients with AN-BP type had longer disease duration history, were older, and had a lower left ventricular ejection fraction (LVEF) (p < 0.001, p = 0.029, p = 0.009) when compared with AN-R type patients who, instead, had significantly higher Alanine Aminotransferase (ALT) and Brain Natriuretic Peptide (BNP) levels (p < 0.001, p < 0.021). In the AN-BP subgroup, as compared to AN-R, lower selenium (p < 0.001) and vitamin B12 plasma concentration (p < 0.036) was observed, whereas lower copper plasma concentration was observed in patients with AN-R type (p < 0.022). No significant differences were observed for zinc, vitamin B9, vitamin D, and vitamin B1 concentrations between the two types of AN patients. Conclusion: Severely malnourished AN patients have many micronutrient deficiencies. Micronutrients status must be monitored and supplemented to prevent deficiency related complications and to improve nutritional status. Prospective studies are needed to explore the symptoms and consequences of each deficiency, which can aggravate the prognosis during recovery.

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Section: Discussionmentioning

confidence: 99%

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

et al. 2019

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“…In addition, patients who have lower serum levels of vitamin D (<20 ng/mL) have lower hip BMD [184]. After weight gain, the spine BMD increase was greater in the group of patients with higher serum vitamin D levels (≥30 ng/mL) [185], supporting the use of oral vitamin D supplements to obtain sufficient serum levels during weight gain. No RCT prospective trial has been performed to evaluate the efficacy of calcium and vitamin D supplements alone on BMD among AN patients.…”

Section: Resultsmentioning

confidence: 99%

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

Blanchet

Guillaume

Bat-Pitault

et al. 2019

JCM

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Drugs are widely prescribed for anorexia nervosa in the nutritional, somatic, and psychiatric fields. There is no systematic overview in the literature, which simultaneously covers all these types of medication. The main aims of this paper are (1) to offer clinicians an overview of the evidence-based data in the literature concerning the medication (psychotropic drugs and medication for somatic and nutritional complications) in the field of anorexia nervosa since the 1960s, (2) to draw practical conclusions for everyday practise and future research. Searches were performed on three online databases, namely MEDLINE, Epistemonikos and Web of Science. Papers published between September 2011 and January 2019 were considered. Evidence-based data were identified from meta-analyses, if there were none, from systematic reviews, and otherwise from trials (randomized or if not open-label studies). Evidence-based results are scarce. No psychotropic medication has proved efficacious in terms of weight gain, and there is only weak data suggesting it can alleviate certain psychiatric symptoms. Concerning nutritional and somatic conditions, while there is no specific, approved medication, it seems essential not to neglect the interest of innovative therapeutic strategies to treat multi-organic comorbidities. In the final section we discuss how to use these medications in the overall approach to the treatment of anorexia nervosa.

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“…Depending on series, 23e58% of eating disorders patients had vitamin D deficiency. A relationship between vitamin D deficiency and BMD decrease, the most frequent chronic complication of AN disease, was found [38]. In addition, hypovitaminosis D3 may be responsible of the lack of inflammatory response and depressive symptoms in patients with long-term eating disorders [39].…”

Section: H) Micronutrients Deficiencymentioning

confidence: 99%

Somatic complications and nutritional management of anorexia nervosa

Gosseaume

Dicembre

Bemer

et al. 2019

Clinical Nutrition Experimental

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Anorexia nervosa (AN) in its two major types (restricting type and binge-eating/purging type) is one of the most frequent and serious eating disorder. Severe undernutrition due to intake restriction and pathological associated behaviors such as potomania and vomiting can cause serious somatic complications such as cardiac and/or hepatic disturbances. Nutritional rehabilitation of undernourished AN patients should be very causes to avoid refeeding syndrome. Managing AN need a multidisciplinary approach including psychiatric and nutritional care.

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Vitamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa

Abstract: Hypovitaminosis D may counteract the efficacy of refeeding in AN through increased bone resorption mediated by secondary hyperparathyroidism, which strongly supports the use of vitamin D supplements for bone health in AN.

Cited by 25 publications

References 39 publications

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients

Medication in AN: A Multidisciplinary Overview of Meta-Analyses and Systematic Reviews

Somatic complications and nutritional management of anorexia nervosa

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