Body Weight Parameters at the Initial Visit for Eating Disorders in Adolescents: Are These the Markers of Serious Complications?

Year 2024, Articles Online First, 1 - 9

Ata Yiğit Çöllü , Demet Taş , Alkım Öden Akman , Esra Çöp

https://doi.org/10.12956/tchd.1499664

Abstract

Objective: Eating disorders (ED) are psychiatric disorders often accompanied by medical complications. This study aimed to identify the complications in ED patients during hospital admission and their relationship with body weight (BW).

Material and Methods: Patients diagnosed with ED per DSM-5 criteria seen at least once in the adolescent department were included. Digital medical records were used to obtain patient information. Body mass index (BMI), BMI percentile, and percentage of BW by height (IBW%) were calculated to analyze their association with medical complications.

Results: Our study included 144 patients, 140 (97.2%) females and 4 (2.8%) males. Of the patients; 94 were analysed as Anorexia Nervosa (AN), 28 as Atypical AN and 17 as Bulimia Nervosa (BN). At least one cardiac complication was detected in 29.3% (39), gastrointestinal complications in 54.2% (78), hypoglycaemia in 18.2% (26), secondary amenorrhoea in 34.5% (48) and 45.8% (66) received inpatient treatment. Patients with IBW%<75 exhibited significantly higher rates of hypoglycemia, bradycardia, low sT3, amenorrhea, and hospitalization compared to those with IBW% ≥ 75 (p<0.001). Bone mineral density (BMD) was significantly inversely associated with Z-score, time to ED diagnosis and duration of amenorrhoea (p=0.006; p=0.044; p=0.032, respectively).

Conclusion: Our findings show that at least one medical complication frequently develops in ED patients at the initial evaluation. Patients with AN and BN, which usually start in adolescence, may frequently present to paediatric outpatient clinics with medical complaints. The role of internal physicians in the early diagnosis of ED is important to prevent serious complications in these patients.

Keywords

Adolescents, Medical complications, Anorexia nervosa, Eating disorder, Bulimia nervosa

Ethical Statement

Araştırmada herhangi bir çıkar çatışması bulunmamaktadır ve etik ihlal yapılmamıştır

Supporting Institution

Bulunmamaktadır

Yeme Bozukluğu Tanılı Ergenlerin İlk Başvurularında Vücut Ağırlığı Parametreleri: Bunlar Ciddi Komplikasyonların Belirteçleri midir?

Abstract

Amaç: Yeme bozuklukları (YB), sıklıkla tıbbi komplikasyonların eşlik ettiği psikiyatrik hastalıklardır. Bu çalışmada, YB hastalarının hastaneye başvuru sırasındaki komplikasyonları ve ilk tanısal başvuru değerlendirmesindeki vücut ağırlığı (VA) ile ilişkisi değerlendirilmiştir.

Gereç ve Yöntemler: Adolesan Sağlığı ve Çocuk Psikiyatrisi değerlendirilmesi ile DSM-5 tanı kriterlerine göre YB tanısı almış hastalar çalışmaya dahil edilmiştir. Hastaların bulguları dijital tıbbi kayıt sisteminden elde edilmiştir. Tıbbi komplikasyonlarla VA ilişkilerini analiz etmek için vücut kitle indeksi (VKİ), VKİ persentili ve boya göre ideal VA yüzdesi (%İVA) hesaplanmıştır.

Bulgular: Çalışmamıza 140’ı (%97.2) kız, 4’ü (%2.8) erkek olmak üzere 144 hasta dahil edildi. Hastaların; 94’ü Anoreksiya Nervoza (AN), 28’i Atipik AN ve 17’si Bulimia Nervoza (BN) olarak değerlendirildi. Hastaların %29.3’ünde (39) en az bir kardiyak, %54.2’sinde (78) gastrointestinal komplikasyon, %18.2’sinde (26) hipoglisemi ve %34.5’inde (48) sekonder amenore saptandı ve %45.8’i (66) ise hastaneye yatırıldı. İVA<%75 olan hastalarda hipoglisemi, bradikardi, düşük serbest triiodotironin (sT3), amenore ve hastaneye yatış oranları İVA≥ %75 olanlara göre istatistiksel anlamlı fazlaydı (p<0.001). Kemik mineral yoğunluğu (KMD) Z-skoru, YB tanısına kadar geçen süre ve amenore süresi ile ters ilişki olduğu saptandı (sırasıyla p=0.006; p=0.044; p=0.032).

Sonuç: Bulgularımız, YB hastalarında ilk değerlendirmede sıklıkla en az bir tıbbi komplikasyonun geliştiğini göstermektedir. Genellikle ergenlik döneminde başlayan AN ve BN hastaları sıklıkla medikal şikayet ile pediatri polikliniklerine başvurabilirler. Bu hastalarda ciddi komplikasyonların önlenmesi için dahili hekimlerin YB erken tanısında rolü önemlidir.

Keywords

Ergen, medikal komplikasyon, yeme bozukluğu, anoreksiya nervoza, blumia nervoza

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