PDF(Pubmed)
Abstract：
BACKGROUND: Avoidant restrictive food intake disorder (ARFID) is a feeding and eating disorder with known acute and longstanding physical health complications in children and young people (CYP) and commonly presents to paediatricians.
OBJECTIVE: To systematically review the published literature on physical health complications in CYP with ARFID using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
METHODS: A systematic search of PubMed, Embase, Web of Science, PsycINFO and Cochrane Library was performed on 14 February 2024. Studies reporting physical health complications in CYP ≤25 years with ARFID were included. We pooled studies for meta-analysis comparing ARFID with healthy controls or anorexia nervosa (AN).
RESULTS: Of 9058 studies found in searches, we included 132 studies. We found evidence for low weight, nutritional deficiencies and low bone mineral density. CYP with ARFID can present across the weight spectrum; however, the majority of CYP with ARFID were within the healthy weight to underweight range. Most studies reported normal range heart rates and blood pressures in ARFID, but some CYP with ARFID do experience bradycardia and hypotension. CYP with ARFID had higher heart rates than AN (weighted mean difference: 12.93 bpm; 95% CI: 8.65 to 17.21; n=685); heterogeneity was high (I2: 81.33%).
CONCLUSIONS: There is a broad range of physical health complications associated with ARFID requiring clinical consideration. Many CYP with ARFID are not underweight yet still have complications. Less cardiovascular complications found in ARFID compared with AN may be related to chronicity.
UNASSIGNED: CRD42022376866.
OBJECTIVE: To systematically review the published literature on physical health complications in CYP with ARFID using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
METHODS: A systematic search of PubMed, Embase, Web of Science, PsycINFO and Cochrane Library was performed on 14 February 2024. Studies reporting physical health complications in CYP ≤25 years with ARFID were included. We pooled studies for meta-analysis comparing ARFID with healthy controls or anorexia nervosa (AN).
RESULTS: Of 9058 studies found in searches, we included 132 studies. We found evidence for low weight, nutritional deficiencies and low bone mineral density. CYP with ARFID can present across the weight spectrum; however, the majority of CYP with ARFID were within the healthy weight to underweight range. Most studies reported normal range heart rates and blood pressures in ARFID, but some CYP with ARFID do experience bradycardia and hypotension. CYP with ARFID had higher heart rates than AN (weighted mean difference: 12.93 bpm; 95% CI: 8.65 to 17.21; n=685); heterogeneity was high (I2: 81.33%).
CONCLUSIONS: There is a broad range of physical health complications associated with ARFID requiring clinical consideration. Many CYP with ARFID are not underweight yet still have complications. Less cardiovascular complications found in ARFID compared with AN may be related to chronicity.
UNASSIGNED: CRD42022376866.
摘要：
背景：避免限制性食物摄入障碍（ARFID）是一种喂养和进食障碍，在儿童和年轻人（CYP）中具有已知的急性和长期身体健康并发症，通常会出现给儿科医生。
目的：使用系统评价和荟萃分析指南的首选报告项目，系统地回顾已发表的关于CYP伴ARFID的身体健康并发症的文献。
方法：对PubMed的系统搜索，Embase,WebofScience,PsycINFO和Cochrane图书馆于2024年2月14日进行。纳入报告CYP≤25年ARFID的身体健康并发症的研究。我们汇总了ARFID与健康对照或神经性厌食症（AN）的荟萃分析研究。
结果：在搜索中发现的9058项研究中，我们纳入了132项研究。我们发现了低体重的证据,营养缺乏和骨密度低。带有ARFID的CYP可以在整个重量范围内呈现；但是，使用ARFID的CYP患者大部分在健康体重至体重不足的范围内.大多数研究报告了ARFID中正常范围的心率和血压，但是一些使用ARFID的CYP确实会出现心动过缓和低血压。使用ARFID的CYP的心率高于AN（加权平均差：12.93bpm；95％CI：8.65至17.21；n=685）；异质性高（I2：81.33％）。
结论：与ARFID相关的身体健康并发症范围广泛，需要临床考虑。许多使用ARFID的CYP体重不足，但仍有并发症。与AN相比，ARFID中发现的心血管并发症较少可能与慢性有关。
■CRD42022376866。
目的：使用系统评价和荟萃分析指南的首选报告项目，系统地回顾已发表的关于CYP伴ARFID的身体健康并发症的文献。
方法：对PubMed的系统搜索，Embase,WebofScience,PsycINFO和Cochrane图书馆于2024年2月14日进行。纳入报告CYP≤25年ARFID的身体健康并发症的研究。我们汇总了ARFID与健康对照或神经性厌食症（AN）的荟萃分析研究。
结果：在搜索中发现的9058项研究中，我们纳入了132项研究。我们发现了低体重的证据,营养缺乏和骨密度低。带有ARFID的CYP可以在整个重量范围内呈现；但是，使用ARFID的CYP患者大部分在健康体重至体重不足的范围内.大多数研究报告了ARFID中正常范围的心率和血压，但是一些使用ARFID的CYP确实会出现心动过缓和低血压。使用ARFID的CYP的心率高于AN（加权平均差：12.93bpm；95％CI：8.65至17.21；n=685）；异质性高（I2：81.33％）。
结论：与ARFID相关的身体健康并发症范围广泛，需要临床考虑。许多使用ARFID的CYP体重不足，但仍有并发症。与AN相比，ARFID中发现的心血管并发症较少可能与慢性有关。
■CRD42022376866。
