Nagata Jason M, Vargas Ruben, Sanders Austin E, Stuart Elena, Downey Amanda E, Chaphekar Anita V, Nguyen Anthony, Ganson Kyle T, Buckelew Sara M, Garber Andrea K
Department of Pediatrics, University of California, San Francisco, California, USA.
Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA.
Int J Eat Disord. 2024 Apr;57(4):1008-1019. doi: 10.1002/eat.24132. Epub 2024 Jan 11.
OBJECTIVE: To describe the clinical characteristics of male adolescents and young adults hospitalized for medical complications of atypical anorexia nervosa (atypical AN) and to compare their clinical characteristics with females with atypical AN and males with anorexia nervosa (AN). METHOD: A retrospective review of electronic medical records for patients with atypical AN and AN aged 9-25 admitted to the UCSF Eating Disorders Program from May 2012 to August 2020 was conducted. RESULTS: Among 21 males with atypical AN (mean age 15.1 ± 2.7, mean %mBMI 102.0 ± 11.8), medical complications evidenced by admission laboratory values included anemia (52.9%), vitamin D insufficiency/deficiency (52.6%), and zinc deficiency (31.6%). Compared with females with atypical AN (n = 69), males with atypical AN had longer length of stay (11.4 vs 8.4 days, p = .004), higher prescribed kcal at discharge (4114 vs 3045 kcal, p < .001), lower heart rate nadir (40.0 vs 45.8, p = .038), higher aspartate transaminase (AST, 37.9 vs 26.2 U/L, p = .032), higher alanine transaminase (ALT, 30.6 vs 18.3 U/L, p = .005), and higher rates of anemia (52.9% vs 19.4%, p = .005), with no differences in vitamin D, zinc, and vital signs. Compared with males with AN (n = 40), males with atypical AN had no significant differences in vital signs or laboratory assessments during the hospitalization. DISCUSSION: Atypical AN in males leads to significant medical comorbidity, and males with atypical AN require longer hospital stays compared to females with atypical AN. Rates of abnormal vital signs and abnormal serum laboratory values during hospital admissions do not differ in males with atypical AN compared to AN. PUBLIC SIGNIFICANCE: Adolescent and young adult males with atypical anorexia nervosa experience significant medical complications. Males with atypical anorexia nervosa had longer hospitalizations and higher prescribed nutrition at discharge than females. Medical complications of atypical anorexia nervosa in male adolescents and young adults were generally equal to those of male adolescents and young adults with anorexia nervosa. Clinicians should be aware of unique medical complications of males with atypical anorexia nervosa.
目的：描述因非典型神经性厌食症（非典型AN）的医学并发症而住院的男性青少年和青年的临床特征，并将他们的临床特征与非典型AN的女性以及神经性厌食症（AN）的男性进行比较。 方法：对2012年5月至2020年8月入住加州大学旧金山分校饮食失调项目的9至25岁非典型AN和AN患者的电子病历进行回顾性研究。 结果：在21名非典型AN男性患者中（平均年龄15.1±2.7岁，平均%mBMI为102.0±11.8），入院实验室检查结果显示的医学并发症包括贫血（52.9%）、维生素D不足/缺乏（52.6%）和锌缺乏（31.6%）。与非典型AN女性患者（n = 69）相比，非典型AN男性患者的住院时间更长（11.4天对8.4天，p = 0.004），出院时规定的千卡摄入量更高（4114千卡对3045千卡，p < 0.001），最低心率更低（40.0对45.8，p = 0.038），天冬氨酸转氨酶（AST，37.9对26.2 U/L，p = 0.032）更高，丙氨酸转氨酶（ALT，30.6对18.3 U/L，p = 0.005）更高，贫血发生率更高（52.9%对19.4%，p = 0.005），维生素D、锌和生命体征方面无差异。与AN男性患者（n = 40）相比，非典型AN男性患者在住院期间的生命体征或实验室评估方面无显著差异。 讨论：男性非典型AN会导致严重的医学合并症，与非典型AN女性相比，非典型AN男性需要更长的住院时间。与AN男性相比，非典型AN男性在入院期间生命体征异常和血清实验室值异常的发生率没有差异。 公共意义：患有非典型神经性厌食症的青少年和青年男性会出现严重的医学并发症。非典型神经性厌食症男性患者的住院时间比女性更长，出院时规定的营养摄入量更高。青少年和青年男性非典型神经性厌食症的医学并发症通常与患有神经性厌食症的青少年和青年男性相同。临床医生应意识到非典型神经性厌食症男性患者独特的医学并发症。
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