Cardiovascular risk in children and adolescents with restrictive type of anorexia nervosa

Anoreksija nervoza (AN) jedan je od poremećaja jedenja koji danas spada među najčešće kronične bolesti kod adolescenata s visokom stopom smrtnosti, a najčešće se veže za ženski spol i adolescentsku dob. Istraživanje je provedeno u suradnji s Centrom za poremećaje u jedenju djece i adolescenata Kliničkog bolničkog centra Sestre milosrdnice Zagreb. Opažajna retrospektivna studija obuhvatila je 183 djevojčice i adolescentice (2005. do 2015. godine) prosječne dobi 14,8 ± 2,5 godina (7 do 23 godine) s dijagnozom AN u trajanju od prosječno 12,8 ± 13,9 mjeseci (0,7 do 108 mjeseci). Prosječan BMI je bio 15,8 ± 1,9 kg/m2 s IBW od 77,7 ± 9,9 % i prosječnim gubitkom na masi od 21,7 ± 9,9 %. Normalan menstrualni ciklus je bio prisutan kod 20,6 % a sekundarnu amenoreju je imalo 74,4 % AN pacijentica. Povećan kardiovaskularni (CVD) rizik utvrđen je kod trećine AN pacijentica (35,5 %) i gotovo polovice restriktivnog tipa AN (47,4 %). Negativna korelacija je utvrđena između ukupnog serumskog kolesterola i BMI-a (r=-0,341). AN pacijentice s povećanim CVD rizikom imaju značajno nižu IBW (p=0,018) I MAC (p=0,041). Značajno više vrijednosti ukupnog kolesterola utvrđene su kod AN pacijentica koje nisu koristile laksative (p=0,046) ili pribjegavale povraćanju (p=0,037) što upućuje na važnost endotipa AN na CVD rizik. Značajno manji broj pacijentica s restriktivnim tipom AN s povećanim CVD rizikom ima normalan menstrualni ciklus u sporedbi s onima niskog CVD rizika (p<0,001).Anorexia nervosa (AN) as one of the eating disorders today and represents one of the most common chronic diseases in adolescents with high mortality rate, mainly related to female gender and adolescent age. The research was conducted in collaboration with Centre for eating disorders in children and adolescents in Sestre milosrdnice University Hospital Center Zagreb. Observational retrospective study included 183 girls (2005 to 2015 period) of average age 14.8 ± 2.5 years (7 to 23 years) diagnosed with AN for an average of 12.8 ± 13.9 months (0.7 to 108 months). Their average BMI was 15.8 ± 1.9 kg/m2 with IBW of 77.7 ± 9.9 % and average weight loss of 21.7 ± 9.9 %. Normal menstrual cycle had 20.6 % and secondary amenorrhea 74.4 % of AN patients. Increased cardiovascular (CVD) risk was found at one third of AN patients (35.5 %) and almost half in restrictive type AN patients (47.4 %). Negative correlation was found between total cholesterol and BMI (r=- 0.341). AN patients with increased CVD risk had significantly lower IBW (p=0.018) and MAC (p=0.041). Significantly higher total cholesterol was found in AN patients who did not take laxatives (p=0.046) or with bulimic episodes (p=0.037) which points out the importance of AN endotype in CVD risk. Significantly fewer restrictive AN patients with increased CVD risk had normal cycle in comparison to those with low CVD risk (p