El Ghoch Marwan, Calugi Simona, Lamburghini Silvia, Dalle Grave Riccardo
Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda (Vr), Italy.
Nutrients. 2014 Sep 23;6(9):3895-912. doi: 10.3390/nu6093895.
The aim of this paper was to conduct a systematic review of body fat distribution before and after partial and complete weight restoration in individuals with anorexia nervosa. Literature searches, study selection, method development and quality appraisal were performed independently by two authors, and data was synthesized using a narrative approach. Twenty studies met the inclusion criteria and were consequently analyzed. The review had five main findings. First, during anorexia nervosa adolescent females lose more central body fat, while adult females more peripheral fat. Second, partial weight restoration leads to greater fat mass deposition in the trunk region than other body regions in adolescent females. Third, after short-term weight restoration, whether partial or complete, adults show a central adiposity phenotype with respect to healthy age-matched controls. Fourth, central fat distribution is associated with increased insulin resistance, but does not adversely affect eating disorder psychopathology or cause psychological distress in female adults. Fifth, the abnormal central fat distribution seems to normalize after long-term maintenance of complete weight restoration, indicating that preferential central distribution of body fat is a transitory phenomenon. However, a discrepancy in the findings has been noted, especially between adolescents and adults; besides age and gender, these appear to be related to differences in the methodology and time of body composition assessments. The PROSPERO Registry-Anorexia Nervosa and Body Fat Distribution: A Systematic Review (CRD42014008738).
本文旨在对神经性厌食症患者部分和完全体重恢复前后的体脂分布进行系统评价。文献检索、研究选择、方法制定和质量评估由两位作者独立进行，并采用叙述性方法对数据进行综合分析。二十项研究符合纳入标准，因此进行了分析。该评价有五项主要发现。第一，在神经性厌食症期间，青春期女性丢失的中心体脂更多，而成年女性丢失的外周体脂更多。第二，部分体重恢复导致青春期女性躯干区域的脂肪量沉积比身体其他区域更多。第三，短期体重恢复后，无论是部分恢复还是完全恢复，与年龄匹配的健康对照组相比，成年人表现出中心性肥胖表型。第四，中心性脂肪分布与胰岛素抵抗增加有关，但对成年女性的饮食失调心理病理学没有不利影响，也不会引起心理困扰。第五，长期维持完全体重恢复后，异常的中心性脂肪分布似乎会恢复正常，这表明体脂的优先中心分布是一种暂时现象。然而，研究结果存在差异，尤其是在青少年和成年人之间；除了年龄和性别外，这些差异似乎与身体成分评估的方法和时间不同有关。PROSPERO注册库——神经性厌食症与体脂分布：一项系统评价（CRD42014008738）。
