Van Leer M, Leistedt S J, Linkowski P, Simon Y
Laboratoire de Recherches psychiatriques, Service de Psychiatrie, Hôpital Erasme, Braine-l'Alleud.
Programme anorexie/boulimie, Association Le Domaine ULB Erasme, Braine-l'Alleud.
Rev Med Brux. 2013 Nov-Dec;34(6):456-61.
Monitoring parameters for anorexia nervosa include clinical, biological and psychological factors. Many research groups are currently trying to identify parameters more likely to predict the severity or the evolution of the illness. Body composition has been proposed as one of those parameters. The aim of the present study is to demonstrate that measures of body composition are more accurate and efficient than the use of body composition index (BMI). We also aim to show that body composition could be used as a prognostic factor in the long-term evolution of patients with anorexia nervosa. It's a retrospective study investigating body composition and BMI in 44 patients treated in a specialized unit for eating disorder. Measures of body composition and BMI were gathered at the time of admission and again 3 months after refeeding onset. Data was correlated to the EDI-2 questionnaire scores. BMI and %FM where found to be increased (P < 0.05) between admission and after 3 months refeeding. The double objective of reaching a BMI value > or = 20 kg/m2 and a %FM value > or = 2% was achieved by 22% of patients. No significant correlation was found between EDI-2 scores and measures of BMI and %FM either on admission or after the 3 months refeeding period. In conclusion, results of our study don't allow concluding for a prognostic superiority of %FM. Nonetheless, BMI currently used as a reference for the monitoring of eating disorders patients seems to lack sensitivity where measures of body composition seem more informative regarding nutritional status. Furthermore, fat mass plays an important role in other clinical manifestations. In addition, measures of body composition should allow more individualised therapeutic support.
神经性厌食症的监测参数包括临床、生物学和心理因素。目前许多研究小组都在试图确定更有可能预测该疾病严重程度或病情发展的参数。身体成分已被提议作为这些参数之一。本研究的目的是证明身体成分测量比使用身体成分指数（BMI）更准确、更有效。我们还旨在表明身体成分可作为神经性厌食症患者长期病情发展的一个预后因素。这是一项回顾性研究，调查了在一家专门治疗饮食失调的单位接受治疗的44名患者的身体成分和BMI。在入院时以及重新进食开始3个月后再次收集身体成分和BMI的测量数据。数据与EDI-2问卷得分相关。发现BMI和%FM在入院时和重新进食3个月后有所增加（P<0.05）。22%的患者达到了BMI值≥20 kg/m²且%FM值≥2%的双重目标。在入院时或重新进食3个月后，未发现EDI-2得分与BMI和%FM测量值之间存在显著相关性。总之，我们的研究结果无法得出%FM在预后方面更具优势的结论。尽管如此，目前用作监测饮食失调患者参考指标的BMI在敏感性方面似乎不足，而身体成分测量在营养状况方面似乎更具信息价值。此外，脂肪量在其他临床表现中起重要作用。此外，身体成分测量应有助于提供更个性化的治疗支持。
