Abstract：
BACKGROUND: Recognition of atypical anorexia nervosa (AAN) has challenged underweight as a defining factor of illness severity in anorexia nervosa (AN). The present study aimed to compare rates of medical instability in adolescents with underweight (AN) and non-underweight (AAN) anorexia nervosa.
METHODS: The study examined assessment data from specialist eating disorder services in the UK between January and December 2022. Participants (n = 205) aged 11-18 years were recruited across eight eating disorder clinics and diagnosed with AN (n = 113) or AAN (n = 92) after clinical assessment. Parameters associated with risk of medical instability were compared between AN and AAN groups, using t tests and regression analysis.
RESULTS: Rates of bradycardia and hypotension did not differ significantly between AN and AAN groups (p = 0.239 and p = 0.289). Although white blood cell counts were lower in the AN group, rates of leukopaenia could not be statistically compared as a result of there being too few counts in at least one group. No incidences of hypophosphataemia were found in the sample. A significant regression equation was found for percentage median body mass index, but not rate of weight loss, as a predictor of blood pressure, serum phosphorous and magnesium.
CONCLUSIONS: Our findings indicate that medical instability occurs across a range of body weights in young people with AN and AAN. Although certain parameters of risk such as blood pressure, serum phosphorous and magnesium may be worsened at lower weight, both AN and AAN are serious mental health conditions that can lead to medical instability.
METHODS: The study examined assessment data from specialist eating disorder services in the UK between January and December 2022. Participants (n = 205) aged 11-18 years were recruited across eight eating disorder clinics and diagnosed with AN (n = 113) or AAN (n = 92) after clinical assessment. Parameters associated with risk of medical instability were compared between AN and AAN groups, using t tests and regression analysis.
RESULTS: Rates of bradycardia and hypotension did not differ significantly between AN and AAN groups (p = 0.239 and p = 0.289). Although white blood cell counts were lower in the AN group, rates of leukopaenia could not be statistically compared as a result of there being too few counts in at least one group. No incidences of hypophosphataemia were found in the sample. A significant regression equation was found for percentage median body mass index, but not rate of weight loss, as a predictor of blood pressure, serum phosphorous and magnesium.
CONCLUSIONS: Our findings indicate that medical instability occurs across a range of body weights in young people with AN and AAN. Although certain parameters of risk such as blood pressure, serum phosphorous and magnesium may be worsened at lower weight, both AN and AAN are serious mental health conditions that can lead to medical instability.
摘要：
背景：对非典型神经性厌食症（AAN）的认识已经挑战了体重不足作为神经性厌食症（AN）疾病严重程度的决定性因素。本研究旨在比较体重不足（AN）和非体重不足（AAN）神经性厌食症青少年的医疗不稳定率。
方法：该研究检查了2022年1月至12月英国饮食失调专科服务的评估数据。11-18岁的参与者（n=205）在8个饮食失调诊所中招募，并在临床评估后被诊断为AN（n=113）或AAN（n=92）。与医疗不稳定风险相关的参数在AN和AAN组之间进行了比较，使用t检验和回归分析。
结果：AN组和AAN组之间的心动过缓和低血压的发生率没有显着差异（p=0.239和p=0.289）。尽管AN组的白细胞计数较低，由于在至少一组中计数过少,因此无法对白细胞减少率进行统计学比较.在样本中没有发现低磷酸盐血症的发生率。发现中位体重指数百分比的回归方程有意义，但不是体重减轻的速度，作为血压的预测指标，血清磷和镁.
结论：我们的研究结果表明，患有AN和AAN的年轻人的体重范围内存在医学不稳定。虽然某些风险参数，如血压，血清磷和镁在体重较低时可能会恶化，AN和AAN都是严重的精神健康状况，可能导致医疗不稳定。
方法：该研究检查了2022年1月至12月英国饮食失调专科服务的评估数据。11-18岁的参与者（n=205）在8个饮食失调诊所中招募，并在临床评估后被诊断为AN（n=113）或AAN（n=92）。与医疗不稳定风险相关的参数在AN和AAN组之间进行了比较，使用t检验和回归分析。
结果：AN组和AAN组之间的心动过缓和低血压的发生率没有显着差异（p=0.239和p=0.289）。尽管AN组的白细胞计数较低，由于在至少一组中计数过少,因此无法对白细胞减少率进行统计学比较.在样本中没有发现低磷酸盐血症的发生率。发现中位体重指数百分比的回归方程有意义，但不是体重减轻的速度，作为血压的预测指标，血清磷和镁.
结论：我们的研究结果表明，患有AN和AAN的年轻人的体重范围内存在医学不稳定。虽然某些风险参数，如血压，血清磷和镁在体重较低时可能会恶化，AN和AAN都是严重的精神健康状况，可能导致医疗不稳定。
