Pediatric Endcrinology Unit, The Edmond and Lily Safra Children's Hospital, Chaim Sheba Medical Center, Tel-Hashomer, Ramat-Gan, 52621, Israel.
The Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, 69978, Israel.
Int J Eat Disord. 2015 Sep;48(6):607-14. doi: 10.1002/eat.22347. Epub 2014 Aug 18.
Previous studies assessing vitamin D status in adolescents with eating disorders showed inconsistent results. The aim of the current study was to assess vitamin D status in a large cohort of adolescent inpatients with eating disorders and its relation to bone mineral density (BMD) and depression.
25-Hydroxyvitamin D (25OHD), calcium, phosphorus, and alkaline phosphatase levels as well as BMD and depression were assessed on admission in 87 inpatients (aged 16 ± 2 years, females = 81) with eating disorders [anorexia nervosa (AN) = 64; bulimia nervosa (BN) = 5; eating disorders not otherwise specified-binge/purge type (EDNOS-B/P) = 18].
Mean 25OHD levels were 24.1 ± 7.5 ng/ml (25.0 ± 7.6, 25.4 ± 9.9, and 22.0 ± 9.9 ng/ml in patients with AB, BN, and EDNOS-B/P, respectively). Vitamin D deficiency (<15 ng/ml) was found in 7.8% of the patients, and insufficiency (15-20 ng/ml) in 22.2%. Only 16.7% had levels >32 ng/ml, considered optimal by some experts. No associations were found between 25OHD levels and BMD or comorbid depression. 25OHD levels during winter were significantly lower than summer levels (p < .001). Mean lumbar spine BMD z-score in patients with AN and EDNOS-B/P type was low (-1.5 ± 1.1) and correlated with body mass index standard deviation score (p = .03).
Adolescents with eating disorders show a high prevalence of vitamin D deficiency and insufficiency. Given the risk of osteoporosis in this population, 25OHD levels found in this group may not offer optimal bone protection. Vitamin D levels should be routinely checked and supplementation should be administered as required.
先前评估青少年进食障碍患者维生素 D 状况的研究结果不一致。本研究旨在评估大量青少年进食障碍住院患者的维生素 D 状况及其与骨密度(BMD)和抑郁的关系。
在 87 名患有进食障碍的住院患者(年龄 16 ± 2 岁,女性=81)入院时评估 25-羟维生素 D(25OHD)、钙、磷和碱性磷酸酶水平以及 BMD 和抑郁情况。进食障碍的分类为神经性厌食(AN)=64 例;神经性贪食(BN)=5 例;未特定的进食障碍-暴食/清除型(EDNOS-B/P)=18 例。
平均 25OHD 水平为 24.1 ± 7.5ng/ml(患者中 AB、BN 和 EDNOS-B/P 的 25OHD 水平分别为 25.0 ± 7.6、25.4 ± 9.9 和 22.0 ± 9.9ng/ml)。7.8%的患者存在维生素 D 缺乏(<15ng/ml),22.2%的患者存在不足(15-20ng/ml)。仅有 16.7%的患者水平>32ng/ml,这被一些专家认为是最佳水平。25OHD 水平与 BMD 或共病抑郁均无相关性。25OHD 水平在冬季显著低于夏季(p<0.001)。AN 和 EDNOS-B/P 型患者的腰椎 BMD z 评分均值较低(-1.5 ± 1.1),且与体重指数标准差评分呈相关性(p=0.03)。
患有进食障碍的青少年存在维生素 D 缺乏和不足的高发率。鉴于该人群骨质疏松的风险,该组患者的 25OHD 水平可能无法提供最佳的骨骼保护。应常规检查 25OHD 水平,并根据需要进行补充。