背景再饲低磷血症(RH)是营养不良个体营养恢复的常见并发症,然而,明确的风险分层仍然难以捉摸。患有神经性厌食症(AN)和回避性/限制性食物摄入障碍(ARFID)的人可能缺乏维生素D,膳食磷在肠道吸收的重要组成部分。在AN和ARFID中维生素D和RH之间的关系尚不清楚。因此,本研究的目的是1)描述AN和ARFID中血清25-羟基维生素D水平和RH低的患病率;2)报告现有文献中最低磷水平与RH相关变量之间的关联;3)研究AN和ARFID中25-羟基维生素D水平与血清磷最低点之间的关系.方法分析包括对急性进食障碍和严重营养不良中心收治的307例诊断为AN或ARFID的患者的回顾性图表回顾。感兴趣的变量包括入院实验室值(维生素D水平,综合代谢小组,血红蛋白,即时血糖),人体测量(体重,体重指数[BMI],%理想体重[IBW]),年龄,疾病的持续时间,逗留时间,喂养方法,和血清磷最低点。皮尔森和斯皮尔曼等级相关,单向方差分析,和回归分析用于确定变量与血清磷之间的关系。结果超过1/3(35.3%)的血清磷水平≤2.9mg/dL。两组之间的磷最低点(p=.17,η2=0.12)或低磷血症(p=.16,φc=0.11)没有显着差异;ARFID患者的44%和AN患者的33%患有低磷血症。最低点磷与体重呈正相关,BMI,%IBW,钾,和入院时的钙,与停留时间呈负相关,血红蛋白,和管饲天数。较高水平的25-羟基维生素D缓解了入院时血清磷最低点与体重之间的关系(p=.0004)。结论诊断为ARFID的个体在维生素D和RH方面与患有AN的个体一样营养脆弱。涉及维持磷稳态的维生素D的负反馈回路可能在AN和ARFID中RH的发展中起作用。
UNASSIGNED: Refeeding hypophosphatemia (RH) is a common complication of nutritional restoration in malnourished individuals, yet clear risk stratification remains elusive. Individuals with anorexia nervosa (AN) and avoidant/restrictive food intake disorder (ARFID) may be deficient in vitamin D, an important component of dietary phosphorus absorption in the gut. The relationship between vitamin D and RH in AN and ARFID is unknown. Therefore, the aims of this of this study were to 1) describe the prevalence of low serum 25-hydroxy vitamin D levels and RH in AN and ARFID 2) report associations between nadir phosphorus level and variables associated with RH in extant literature and 3) examine the relationship between 25-hydroxy vitamin D levels and serum phosphorus nadir in AN and ARFID.
UNASSIGNED: Analyses included retrospective chart review of 307 individuals admitted to the ACUTE Center for Eating Disorders and Severe Malnutrition with a diagnosis of AN or ARFID. Variables of interest included admission laboratory values (vitamin D level, comprehensive metabolic panel, hemoglobin, point-of-care blood glucose), anthropometric measures (weight, body mass index [BMI], % ideal body weight [IBW]), age, duration of illness, length of stay, feeding method, and serum phosphorus nadir. Pearson and Spearman rank correlation, one-way ANOVA, and regression analyses were used to determine the relationship between variables and serum phosphorus.
UNASSIGNED: Over 1/3 of the sample (35.3%) had serum phosphorus levels ≤ 2.9 mg/dL. There were no significant differences between groups in phosphorus nadir (p = .17, η2 = 0.12) or hypophosphatemia (p = .16, ϕc = 0.11); 44% of individuals with ARFID and 33% of individuals with AN had hypophosphatemia. Nadir phosphorus showed a positive association with weight, BMI, %IBW, potassium, and calcium on admission, and a negative association with length of stay, hemoglobin, and total number of tube-fed days. Higher levels of 25-hydroxy vitamin D moderated the relationship between serum phosphorus nadir and weight on admission (p = .0004).
UNASSIGNED: Individuals diagnosed with ARFID are as nutritionally fragile as those with AN regarding vitamin D and RH. The negative feedback loop involving vitamin D that maintains phosphorus homeostasis may play a role in the development of RH in AN and ARFID.