Nagata Jason M, Grandis Anna, Bojorquez-Ramirez Paola, Nguyen Anthony, Downey Amanda E, Ganson Kyle T, Patel Khushi P, Machen Vanessa I, Buckelew Sara M, Garber Andrea K
Department of Pediatrics, University of California, 550 16th Street, 4th Floor, Box 0110, San Francisco, CA, 94143, USA.
Yale School of Public Health, Yale University, New Haven, CT, 06510, USA.
J Eat Disord. 2022 Jul 18;10(1):104. doi: 10.1186/s40337-022-00627-5.
Medical complications of eating disorders in males are understudied compared to females, as is the case of vitamin D deficiency. The aim of this study was to assess vitamin D levels among male and female adolescents and young adults hospitalized for medical complications of eating disorders.
We retrospectively reviewed electronic medical records of patients aged 9-25 years (N = 565) admitted to the University of California, San Francisco Eating Disorders Program for medical instability, between May 2012 and August 2020. Serum vitamin D (25-hydroxy) level was assessed at admission as was history of prior calcium, vitamin D, or multivitamin supplementation. Linear regression was used to assess factors associated with vitamin D levels.
A total of 93 males and 472 females met eligibility criteria (age 15.5 ± 2.8, 58.8% anorexia nervosa; admission body mass index 17.6 ± 2.91). Among male participants, 44.1% had 25-hydroxyvitamin D levels < 30 ng/mL, 18.3% had 25-hydroxyvitamin D levels < 20 ng/mL, and 8.6% had 25-hydroxyvitamin D levels < 12 ng/mL. There were no significant differences in 25-hydroxyvitamin D levels in males compared to females, except that a lower proportion (1.9%) of female participants had 25-hydroxyvitamin D levels < 12 ng/mL (p = 0.001). Only 3.2% of males reported calcium or vitamin D-specific supplementation prior to hospital admission, while 8.6% reported taking multivitamins. White race, prior calcium/vitamin D supplementation, and higher calcium levels were associated with higher vitamin D levels on admission.
Nearly half of patients admitted to the hospital for malnutrition secondary to eating disorders presented with low 25-hydroxyvitamin D levels; males were more likely than females to have severe vitamin D deficiency. These findings support vitamin D assessment as part of the routine medical/nutritional evaluation for hospitalized eating disorder patients, with particular attention on male populations.
与女性相比,男性饮食失调的医学并发症研究较少,维生素D缺乏情况也是如此。本研究的目的是评估因饮食失调医学并发症而住院的男性和女性青少年及青年成人的维生素D水平。
我们回顾性分析了2012年5月至2020年8月期间因医疗不稳定入住加利福尼亚大学旧金山分校饮食失调项目的9至25岁患者(N = 565)的电子病历。入院时评估血清维生素D(25-羟维生素D)水平以及既往钙、维生素D或多种维生素补充剂的使用史。采用线性回归分析与维生素D水平相关的因素。
共有93名男性和472名女性符合纳入标准(年龄15.5±2.8岁,58.8%为神经性厌食症;入院时体重指数17.6±2.91)。在男性参与者中,44.1%的25-羟维生素D水平<30 ng/mL,18.3%的25-羟维生素D水平<20 ng/mL,8.6%的25-羟维生素D水平<12 ng/mL。与女性相比,男性的25-羟维生素D水平无显著差异,只是女性参与者中25-羟维生素D水平<12 ng/mL的比例较低(1.9%)(p = 0.001)。只有3.2%的男性报告在入院前补充过钙或特定的维生素D,而8.6%的男性报告服用过多种维生素。白种人、既往补充过钙/维生素D以及较高的钙水平与入院时较高的维生素D水平相关。
因饮食失调继发营养不良而住院的患者中,近一半患者的25-羟维生素D水平较低;男性比女性更易出现严重维生素D缺乏。这些发现支持将维生素D评估作为住院饮食失调患者常规医学/营养评估的一部分,尤其要关注男性群体。