Iverson Health Innovation Research Institute, Swinburne University of Technology, Melbourne, Victoria, Australia.
Department of Mental Health, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Psychophysiology. 2021 Nov;58(11):e13913. doi: 10.1111/psyp.13913. Epub 2021 Jul 28.
Cardiovascular complications have been demonstrated in patients with anorexia nervosa (AN) in both the state of starvation and during weight restoration, however, the underlying mechanisms remain unclear. The current study aimed to assess arterial stiffness via carotid-femoral pulse wave velocity (cfPWV) in the acute and weight-restored states of AN. The study also aimed to determine the association between psychological distress and cfPWV. The sample included 37 participants; 10 participants with AN, 17 who were weight-restored (AN-WR; minimum body mass index >18.5 for at least 12 months) and 10 healthy controls (HCs). cfPWV via applanation tonometry was conducted to assess arterial stiffness. Psychological distress was assessed using the depression anxiety stress scale (DASS-21) and the state-trait anxiety inventory (STAI). Between-group comparisons were performed to determine differences between groups, a two-stage hierarchical regression model was performed to determine the contribution of physiological and psychological variables on cfPWV and correlation analyses were also performed. Vascular stiffness was significantly increased in the AN and AN-WR groups, relative to HCs. The total DASS score was the only significant predictor of cfPWV across the sample. There were positive associations between cfPWV and depression, anxiety and stress, as assessed by the DASS. Furthermore, cfPWV was positively associated with STAI trait anxiety. Arterial stiffness was increased in individuals in the acute and weight-restored states of AN, demonstrating early signs of the development of arteriosclerotic cardiovascular disease. Increased arterial stiffness was associated with increased psychological distress, which may be a contributing mechanism to the increased cardiovascular risk in AN.
在处于饥饿状态和体重恢复期间，神经性厌食症（AN）患者均表现出心血管并发症，但潜在机制尚不清楚。本研究旨在通过颈股脉搏波速度（cfPWV）评估 AN 的急性和体重恢复状态下的动脉僵硬度，并确定心理困扰与 cfPWV 之间的关联。研究对象包括 37 名参与者，其中 10 名 AN 患者、17 名 AN 体重恢复者（至少 12 个月 BMI>18.5）和 10 名健康对照者（HCs）。使用平板张力测量法进行 cfPWV 以评估动脉僵硬度。采用抑郁焦虑压力量表（DASS-21）和状态特质焦虑量表（STAI）评估心理困扰。进行组间比较以确定组间差异，进行两阶段分层回归模型以确定生理和心理变量对 cfPWV 的贡献，并进行相关性分析。与 HCs 相比，AN 和 AN-WR 组的血管僵硬度显著增加。在整个样本中，DASS 总分是 cfPWV 的唯一显著预测因子。DASS 评估的 cfPWV 与抑郁、焦虑和压力呈正相关。此外，cfPWV 与 STAI 特质焦虑呈正相关。AN 急性和体重恢复状态下的个体动脉僵硬度增加，表明动脉粥样硬化性心血管疾病的发展早期迹象。动脉僵硬度增加与心理困扰增加相关，这可能是 AN 中心血管风险增加的一个促成机制。
