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神经性厌食症和神经性贪食症临床及代谢特征的比较与预测分析

Comparative and Predictive Analysis of Clinical and Metabolic Features of Anorexia Nervosa and Bulimia Nervosa.

作者信息

Dönmez Reyhan Betül, Demirel Tuğba Nur, Bilgin Cem, Tarhan Nevzat, Örkçü Özden, Ceylan Zeynep, Guleken Zozan

机构信息

Faculty of Medicine, Üsküdar University, Istanbul, Turkey.

Department of Physiatry, Üsküdar University, NP Hospital, Istanbul, Turkey.

出版信息

Addict Health. 2023 Oct;15(4):230-239. doi: 10.34172/ahj.2023.1466. Epub 2023 Oct 29.

Abstract

BACKGROUND

Eating disorders have become increasingly prevalent over the years; the age at which they appear has decreased, and they can lead to serious illness or death. Therefore, the number of studies on the matter has increased. Eating disorders like anorexia nervosa (AN) and bulimia nervosa (BN) are affected by many factors including mental illnesses that can have serious physical and psychological consequences. Accordingly, the present study aimed to compare the clinical and metabolic features of patients with AN and BN and identify potential biomarkers for distinguishing between the two disorders.

METHODS

Clinical data of 41 participants who sought treatment for eating disorders between 2012 and 2022, including 29 AN patients and 12 BN patients, were obtained from NPIstanbul Brain Hospital in Istanbul, Turkey. The study included the clinical variables of both outpatient and inpatient treatments. Principal component analysis (PCA) was utilized to gain insights into differentiating AN and BN patients based on clinical characteristics, while machine learning techniques were applied to identify eating disorders.

FINDINGS

The study found that thyroid hormone levels in patients with AN and BN were influenced by non-thyroidal illness syndrome (NTIS), which could be attributed to various factors, including psychiatric disorders, substance abuse, and medication use. Lipid profile comparisons revealed higher triglyceride levels in the BN group (<0.05), indicating increased triglyceride synthesis and storage as an energy source. Liver function tests showed lower levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in BN patients (<0.05), while higher prolactin levels (<0.05) suggested an altered hypothalamic-pituitary-gonadal axis. Imbalances in minerals such as calcium and magnesium (<0.05) were observed in individuals with eating disorders. PCA effectively differentiated AN and BN patients based on clinical features, and the Naïve Bayes (NB) model showed promising results in identifying eating disorders.

CONCLUSION

The findings of the study provide important insights into AN and BN patients' clinical features and may help guide future research and treatment strategies for these conditions.

摘要

背景

多年来,饮食失调症日益普遍;其出现的年龄有所降低,且可能导致严重疾病或死亡。因此,关于这一问题的研究数量有所增加。神经性厌食症(AN)和神经性贪食症(BN)等饮食失调症受多种因素影响,包括可能产生严重身体和心理后果的精神疾病。据此,本研究旨在比较AN和BN患者的临床和代谢特征,并确定区分这两种疾病的潜在生物标志物。

方法

从土耳其伊斯坦布尔的NPIstanbul脑科医院获取了2012年至2022年间因饮食失调症寻求治疗的41名参与者的临床数据,其中包括29名AN患者和12名BN患者。该研究纳入了门诊和住院治疗的临床变量。主成分分析(PCA)用于深入了解基于临床特征区分AN和BN患者的情况,同时应用机器学习技术来识别饮食失调症。

研究结果

该研究发现,AN和BN患者的甲状腺激素水平受非甲状腺疾病综合征(NTIS)影响,这可能归因于多种因素,包括精神疾病、药物滥用和药物使用。血脂谱比较显示,BN组的甘油三酯水平较高(<0.05),表明甘油三酯合成和储存作为能量来源增加。肝功能测试显示,BN患者的天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)水平较低(<0.05),而催乳素水平较高(<0.05)表明下丘脑 - 垂体 - 性腺轴发生改变。在饮食失调症患者中观察到钙和镁等矿物质失衡(<0.05)。PCA基于临床特征有效区分了AN和BN患者,朴素贝叶斯(NB)模型在识别饮食失调症方面显示出有前景的结果。

结论

该研究结果为AN和BN患者的临床特征提供了重要见解,并可能有助于指导针对这些病症的未来研究和治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a35/10843349/4b510b965f8f/ahj-15-230-g001.jpg

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