Biochemical and hematological parameters of patients with eating disordered behaviours
Main Article Content
Keywords
Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Eating Disorders, Minerals, Vitamins.
Abstract
Background and aim: Eating Disorders (EDs) are serious mental illnesses that can affect people's health and overall well-being irrespective of age, gender, ethnicity, or socioeconomic status. The current study aims to determine selected biochemical and hematological parameters of Saudi women with various types of disordered eating behaviors.
Methods: This cross-sectional study recruited 100 eating-disordered women, who aged 20-40 years at Taibah University. Blood samples were collected from participants to determine selected micronutrients' levels such as iron, vitamin D, folate, vitamin B12, serum electrolytes, as well as levels of thyroid hormones (T3 and T4). Blood samples were analyzed using immunoassay methods. GraphPad Prism 7 was used for the statistical analysis of the results.
Results: The EAT-26 test and the DSM-5 test results indicated that women suffered from three types of EDs, specifically, Anorexia Nervosa (18%), Bulimia Nervosa (32%), and Binge Eating Disorder (50%).Low serum iron, vitamin D, vitamin B12, calcium, magnesium, and albumin were prevalent among AN patients compared to their counterparts. The multivariate analysis results indicated a strong or moderate correlation among the variables in AN, BN and BED patients, with a negative correlation between serum P and serum vitamin D, and between serum Ca and Serum P in AN, BN and BED patients.
Conclusions: The research provides an insight into the various biochemical and hematological abnormalities among women with eating disordered behaviors at a university in Saudi Arabia and emphasizes the need for widespread screening for females in order to identify those individuals who may be suffering from such eating disorders.
References
2. Quiles Marcos Y, Quiles Sebastián MJ, Pamies Aubalat L, Botella Ausina J, Treasure J. Peer and family influence in eating disorders: A meta-analysis. European Psychiatry. 2012;28: 199–206. doi:10.1016/j.eurpsy.2012.03.005
3. Zeeni N, Gharibeh N, Katsounari I. The influence of sociocultural factors on the eating attitudes of Lebanese and Cypriot students: a cross-cultural study. Journal of Human Nutrition and Dietetics. 2013;26: 45–52. doi:10.1111/jhn.12059
4. The culture and customs of Saudi Arabia. Choice Reviews Online. 2006;43: 43–3793. doi:10.5860/choice.43-3793
5. Sato Y, Fukudo S. Gastrointestinal symptoms and disorders in patients with eating disorders. Clinical Journal of Gastroenterology. 2015;8: 255–263. doi:10.1007/s12328-015-0611-x
6. Brown CA, Sabel AL, Gaudiani JL, Mehler PS. Predictors of hypophosphatemia during refeeding of patients with severe anorexia nervosa. International Journal of Eating Disorders. 2015;48: 898–904. doi:10.1002/eat.22406
7. Zeytinoglu M, Jain RK, Vokes TJ. Vertebral fracture assessment: Enhancing the diagnosis, prevention, and treatment of osteoporosis. Bone. 2017;104: 54–65. doi:10.1016/j.bone.2017.03.004
8. Hong S, Ferraro CS, Hamilton BK, Majhail NS. To D or not to D: vitamin D in hematopoietic cell transplantation. Bone Marrow Transplantation. 2020;55: 2060–2070. doi:10.1038/s41409-020-0904-7
9. Maghrabi AH, Wolski K, Abood B, Licata A, Pothier C, Bhatt DL, et al. Two-year outcomes on bone density and fracture incidence in patients with T2DM randomized to bariatric surgery versus intensive medical therapy. Obesity. 2015;23: 2344–2348. doi:10.1002/oby.21150
10. Ćwiek-Ludwicka K. The 70 year anniversary of the Roczniki Państwowego Zakładu Higieny / Annals of the National Institute of Hygiene. Roczniki Państwowego Zakładu Higieny. 2019; 111–117. doi:10.32394/rpzh.2019.0060
11. Romano C, van Wynckel M, Hulst J, Broekaert I, Bronsky J, Dall’Oglio L, et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children With Neurological Impairment. Journal of Pediatric Gastroenterology & Nutrition. 2017;65: 242–264. doi:10.1097/mpg.0000000000001646
12. Giovinazzo S, Sukkar SG, Rosa GM, Zappi A, Bezante GP, Balbi M, et al. Anorexia nervosa and heart disease: a systematic review. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity. 2018;24: 199–207. doi:10.1007/s40519-018-0567-1
13. Pengpid S, Peltzer K, Ahsan GU. Risk of eating disorders among university students in Bangladesh. International Journal of Adolescent Medicine and Health. 2015;27: 93–100. doi:10.1515/ijamh-2014-0013
14. Rogoza R, Brytek-Matera A, Garner D. Analysis of the EAT-26 in a non-clinical sample. Archives of Psychiatry and Psychotherapy. 2016;18: 54–58. doi:10.12740/app/63647
15. Galmiche M, Déchelotte P, Lambert G, Tavolacci MP. Prevalence of eating disorders over the 2000–2018 period: a systematic literature review. The American Journal of Clinical Nutrition. 2019;109: 1402–1413. doi:10.1093/ajcn/nqy342
16. Meyer LB, Waaddegaard M, Lau ME, Tjørnhøj-Thomsen T. (Dis-)solving the Weight Problem in Binge-Eating Disorder: Systemic Insights From Three Treatment Contexts With Weight Stability, Weight Loss, and Weight Acceptance. Qualitative Health Research. 2018;29: 597–608. doi:10.1177/1049732318764874
17. Lampe EW, Forman EM, Juarascio AS, Manasse SM. Feasibility, Acceptability, and Preliminary Target Engagement of a Healthy Physical Activity Promotion Intervention for Bulimia Nervosa: Development and Evaluation via Case Series Design. Cognitive and Behavioral Practice. 2022;29: 598–613. doi:10.1016/j.cbpra.2021.05.006
18. Moskowitz R, Schecter A, Sala M. Combined Mindfulness- and Acceptance-Based Therapy and Cognitive Behavioral Therapy Treatments for Eating Disorders: A Narrative Review. Journal of Contemporary Psychotherapy. 2022. doi:10.1007/s10879-022-09556-5
19. The Lancet. Eating disorders: innovation and progress urgently needed. The Lancet. 2020;395: 840. doi:10.1016/s0140-6736(20)30573-0
20. McClain CJ, Stuart MA, Vivian B, McClain M, Talwalker R, Snelling L, et al. Zinc status before and after zinc supplementation of eating disorder patients. Journal of the American College of Nutrition. 1992;11: 694–700. doi:10.1080/07315724.1992.10718269
21. Alwosaifer AM, Alawadh SA, Wahab MMA, Boubshait LA, Almutairi BA. Eating disorders and associated risk factors among Imam Abdulrahman bin Faisal university preparatory year female students in Kingdom of Saudi Arabia. Saudi Medical Journal. 2018;39: 910–921. doi:10.15537/smj.2018.9.23314
22. Markiewicz-Żukowska R, Gutowska A, Borawska MH. Serum Zinc Concentrations Correlate with Mental and Physical Status of Nursing Home Residents. van Wouwe J, editor. PLOS ONE. 2015;10: e0117257. doi:10.1371/journal.pone.0117257
23. Jahnen-Dechent W, Ketteler M. Magnesium basics. Clinical Kidney Journal. 2012;5: i3–i14. doi:10.1093/ndtplus/sfr163
24. Kirov GK, Birch NJ, Steadman P, Ramsey RG. Plasma Magnesium Levels in a Population of Psychiatric Patients: Correlations with Symptoms. Neuropsychobiology. 1994;30: 73–78. doi:10.1159/000119139
25. GOLDEN N, KATZMAN D, KREIPE R, STEVENS S, SAWYER S, REES J, et al. Eating disorders in adolescentsposition paper of the Society for Adolescent Medicine. Journal of Adolescent Health. 2003;33: 496–503. doi:10.1016/s1054-139x(03)00326-4
26. Miller KK. Medical Findings in Outpatients With Anorexia Nervosa. Archives of Internal Medicine. 2005;165: 561. doi:10.1001/archinte.165.5.561
27. Modan-Moses D, Levy-Shraga Y, Pinhas-Hamiel O, Kochavi B, Enoch-Levy A, Vered I, et al. High prevalence of vitamin D deficiency and insufficiency in adolescent inpatients diagnosed with eating disorders. International Journal of Eating Disorders. 2014;48: 607–614. doi:10.1002/eat.22347
28. Mehler PS, Blalock DV, Walden K, Kaur S, McBride J, Walsh K, et al. Medical findings in 1,026 consecutive adult inpatient-residential eating disordered patients. International Journal of Eating Disorders. 2018;51: 305–313. doi:10.1002/eat.22830
29. Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. The Lancet Diabetes & Endocrinology. 2014;2: 76–89. doi:10.1016/s2213-8587(13)70165-7
30. Simona Giordano. Anorexia and Refusal of Life-Saving Treatment: The Moral Place of Competence, Suffering, and the Family. Philosophy, Psychiatry, & Psychology. 2010;17: 143–154. doi:10.1353/ppp.0.0286
31. Crow SJ, Rosenberg ME, Mitchell JE, Thuras P. Urine electrolytes as markers of bulimia nervosa. International Journal of Eating Disorders. 2001;30: 279–287. doi:10.1002/eat.1085
32. Nitsch A, Dlugosz H, Gibson D, Mehler PS. Medical complications of bulimia nervosa. Cleveland Clinic Journal of Medicine. 2021;88: 333–343. doi:10.3949/ccjm.88a.20168
33. Prohaska JR. Trace Elements in Human and Animal Nutrition, 5th ed. The Journal of Nutrition. 1989;119: 831. doi:10.1093/jn/119.5.831
34. Setnick J. Micronutrient Deficiencies and Supplementation in Anorexia and Bulimia Nervosa. Nutrition in Clinical Practice. 2010;25: 137–142. doi:10.1177/0884533610361478
35. DiBaise M, Tarleton SM. Hair, Nails, and Skin: Differentiating Cutaneous Manifestations of Micronutrient Deficiency. Nutrition in Clinical Practice. 2019;34: 490–503. doi:10.1002/ncp.10321
36. Mitchell JE, Crow S. Medical complications of anorexia nervosa and bulimia nervosa. Current Opinion in Psychiatry. 2006;19: 438–443. doi:10.1097/01.yco.0000228768.79097.3e
37. Corbetta F, Tremolizzo L, Conti E, Ferrarese C, Neri F, Bomba M, et al. Paradoxical increase of plasma vitamin B12and folates with disease severity in anorexia nervosa. International Journal of Eating Disorders. 2014;48: 317–322. doi:10.1002/eat.22371