Berkowitz Staci A, Witt Ashley A, Gillberg Christopher, Råstam Maria, Wentz Elisabet, Lowe Michael R
Department of Psychology, Drexel University, Philadelphia, Pennsylvania.
Gillberg Neuropsychiatry Center, Institute of Neuroscience and Physiology, University of Göteborg, Sweden.
Int J Eat Disord. 2016 Nov;49(11):1002-1009. doi: 10.1002/eat.22584. Epub 2016 Jul 27.
Although weight history is relevant in predicting eating disorder symptom severity, little is known about its role in the etiology of anorexia nervosa (AN). This study aimed to determine whether BMI or BMI trajectory differed between individuals who later developed adolescent-onset AN and a comparison group of HCs between school grades 1 through 6.
This study was based on longitudinal data that identified 51 adolescents with AN and 51 matched HCs. Cases were identified through community screening in Sweden and included individuals born in 1969 through 1977. Measured weights and heights were retrieved and BMIs and weight trajectories of the AN and HC groups were compared using growth curve analysis. Main outcome measures included measured BMI and BMI trajectories from grades 1-6. Secondary outcomes examined included ponderal index at birth and maternal body weight.
Individuals who later developed AN had higher BMIs than HCs between grades 1 and 6, by an average of 1.42 BMI-units. There was no difference in rate of weight gain between groups. Ponderal index at birth was higher for the AN as compared with HC group. Maternal weight did not differ significantly between groups.
These findings, combined with those previously reported on the premorbid BMIs of those with bulimia nervosa, suggest that a predisposition toward elevated premorbid BMIs during childhood characterizes those who later develop anorexia or bulimia nervosa. These findings are consistent with a transdiagnostic perspective and suggest shared risk factors for AN and obesity. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1002-1009).
尽管体重史与预测饮食失调症状严重程度相关，但对于其在神经性厌食症（AN）病因学中的作用却知之甚少。本研究旨在确定后来发生青春期起病型AN的个体与1至6年级的健康对照（HC）组相比，其体重指数（BMI）或BMI轨迹是否存在差异。
本研究基于纵向数据，确定了51名患有AN的青少年和51名匹配的HC。通过瑞典的社区筛查确定病例，包括1969年至1977年出生的个体。检索测量的体重和身高，并使用生长曲线分析比较AN组和HC组的BMI及体重轨迹。主要结局指标包括1至6年级测量的BMI和BMI轨迹。检查的次要结局包括出生时的 ponderal指数和母亲体重。
后来发生AN 的个体在1至6年级时的BMI高于HC，平均高出1.42个BMI单位。两组之间的体重增加率没有差异。与HC组相比，AN组出生时的ponderal指数更高。两组之间母亲体重没有显著差异。
这些发现，结合先前关于神经性贪食症患者病前BMI的报道，表明童年时期病前BMI升高的易感性是后来发生神经性厌食症或神经性贪食症的人的特征。这些发现与跨诊断观点一致，并表明AN和肥胖存在共同的危险因素。©2016威利期刊公司（《国际进食障碍杂志》2016；49：1002 - 1009）
