住院青少年和年轻成人群体中，饮食失调患者的胆固醇和甘油三酯水平的性别差异。
Sex differences in cholesterol and triglyceride levels among hospitalized adolescents and young adults with eating disorders.
机构信息
Department of Pediatrics, University of California, San Francisco, California, USA.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA.
出版信息
Int J Eat Disord. 2024 Jan;57(1):184-194. doi: 10.1002/eat.24072. Epub 2023 Oct 20.
OBJECTIVE
To determine sex differences in cholesterol and triglyceride levels among adolescents and young adults hospitalized for medical complications of eating disorders.
METHODS
A retrospective electronic medical record review of patients aged 9-25 years admitted to the University of California, San Francisco Eating Disorders Program for medical stabilization, between 2012 and 2020, was conducted. Non-fasting total cholesterol and triglycerides were collected; however, LDL and HDL levels were not available.
RESULTS
Among 83 males and 441 females, mean ± SD age was 15.5 ± 2.8 years, 64.1% had anorexia nervosa, and admission percent median body mass index was 87.3 ± 13.9. The proportion of males and females with high total cholesterol (13.3% vs. 18.1%, Cramer's V = 0.05, p = .28) and high triglyceride levels (9.6% vs. 8.1%, Cramer's V = 0.02, p = .63) did not differ. Mean total cholesterol levels were higher in females compared to males (F 169.6 ± 41.1 mg/dL vs. M 154.5 ± 45.1 mg/dL, Cohen's d = 0.36, p = .003), although a majority were within the normal range. In adjusted linear regression models, male (compared to female) sex (B = -14.40, 95% CI -24.54, -4.27) and higher percent median body mass index (B = -0.33, 95% CI -0.60, -0.06) were associated with lower total cholesterol levels in adjusted models (R = 0.04).
DISCUSSION
Building on prior work showing equally severe complications of eating disorders in males compared to females, we did not find sex differences in those presenting with high total cholesterol or triglycerides. Future research is needed to understand the pathophysiology and role of dyslipidemia in acute malnutrition, and the impact of nutritional rehabilitation and weight restoration.
PUBLIC SIGNIFICANCE
We found that the proportion of male and female adolescents and young adults hospitalized for medical complications of an eating disorder with high total cholesterol did not significantly differ. Although average total cholesterol levels were higher in female compared to male patients with eating disorders, a majority of these levels remained within the normal range. Patients with more severe malnutrition had a higher risk of elevated total cholesterol levels. Clinicians should consider monitoring cholesterol levels in young people hospitalized for restrictive eating disorders.
目的
确定因饮食失调而住院的青少年和年轻人中胆固醇和甘油三酯水平的性别差异。
方法
对 2012 年至 2020 年间因医疗稳定入住加利福尼亚大学旧金山饮食失调计划的年龄在 9-25 岁的患者进行了回顾性电子病历审查。收集了非空腹总胆固醇和甘油三酯；然而，无法获得 LDL 和 HDL 水平。
结果
在 83 名男性和 441 名女性中，平均年龄为 15.5±2.8 岁，64.1%患有神经性厌食症，入院时中位数体重指数为 87.3±13.9。高总胆固醇（13.3%比 18.1%，Cramer's V=0.05，p=0.28）和高甘油三酯水平（9.6%比 8.1%，Cramer's V=0.02，p=0.63）的男性和女性比例没有差异。女性的总胆固醇水平高于男性（F 169.6±41.1mg/dL 比 M 154.5±45.1mg/dL，Cohen's d=0.36，p=0.003），尽管大多数仍在正常范围内。在调整后的线性回归模型中，与女性相比，男性（B=-14.40，95%置信区间-24.54，-4.27）和更高的中位数体重指数百分比（B=-0.33，95%置信区间-0.60，-0.06）与调整后的总胆固醇水平较低相关（R2=0.04）。
讨论
在先前的研究表明男性和女性饮食失调并发症同样严重的基础上，我们没有发现胆固醇升高的青少年和年轻男性和女性之间存在性别差异。需要进一步研究以了解急性营养不良中血脂异常的病理生理学和作用，以及营养康复和体重恢复的影响。
意义
我们发现，因饮食失调并发症住院的青少年和年轻男性与女性中高总胆固醇的比例没有显著差异。尽管与患有饮食失调症的男性患者相比，女性患者的平均总胆固醇水平更高，但这些水平中的大多数仍在正常范围内。营养不良程度越严重的患者，总胆固醇水平升高的风险越高。临床医生应考虑监测因限制进食而住院的年轻人的胆固醇水平。
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