O'Brien Michael, Quirke Rachael, Gowan Roisin, McNicholas Fiona
Maudsley Hospital, South London and Maudsley NHS Foundation Trust, London, UK.
Department of Psychiatry, School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.
Eur Child Adolesc Psychiatry. 2025 Apr;34(4):1281-1293. doi: 10.1007/s00787-024-02576-7. Epub 2024 Sep 6.
Thiamine is an essential vitamin that plays a crucial role in many biochemical processes in the body. Anorexia nervosa (AN) is one potential cause of a state of deficiency which can result in grave medical sequelae. There is limited available evidence of the prevalence of thiamine deficiency in patients who suffer from AN. The current study aimed to systematically review all available evidence on the prevalence of thiamine deficiency in cohorts with AN. Studies were included where thiamine status in a group of participants with AN was measured, either through self-reporting or objective measurement. Eight databases (Scopus, CINAHL complete, Medline complete, EMBASE, WEB OF SCIENCE, PROSPERO, COCHRANE DATABASE OF SYSTEMATIC REVIEWS and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. PRISMA guidelines were followed. The study was registered on PROSPERO. A minimum of two researchers conducted each part of the review. The search identified 42 articles whose full texts were screened for eligibility, with 17 retained for qualitative synthesis. The prevalence rates of thiamine deficiency in AN varied from 5.9% to 100% when based on self-report dietary intake. When objective measurements were taken, rates ranged from 0% to 56.7%. The review suggested that age, body mass index (BMI), duration of illness and subtype of AN were not associated with thiamine status. The limited available evidence suggested that the use of supplements, prior treatment and higher energy intakes were associated with a reduced risk of developing a thiamine deficiency among individuals with AN. Poor study methodology including small sample size, inconsistent deficiency definition and study heterogeneity limits the conclusions that can be drawn. Ultimately, there is insufficient strength of evidence to draw definitive clinical recommendations. This review highlights the need for further studies with more robust methodology to help further inform clinical practice.
硫胺素是一种必需维生素，在人体许多生化过程中起着关键作用。神经性厌食症（AN）是导致缺乏状态的一个潜在原因，可能会引发严重的医学后遗症。关于AN患者硫胺素缺乏症患病率的现有证据有限。本研究旨在系统回顾关于AN队列中硫胺素缺乏症患病率的所有现有证据。纳入的研究需测量一组AN参与者的硫胺素状态，测量方式可以是自我报告或客观测量。检索了八个数据库（Scopus、CINAHL complete、Medline complete、EMBASE、科学网、PROSPERO、Cochrane系统评价数据库和Cochrane对照试验中央注册库（CENTRAL））。遵循PRISMA指南。该研究已在PROSPERO上注册。至少两名研究人员进行了综述的每个部分。检索到42篇文章，对其全文进行了资格筛选，17篇被保留用于定性综合分析。基于自我报告的饮食摄入量，AN患者硫胺素缺乏症的患病率在5.9%至100%之间。进行客观测量时，患病率在0%至56.7%之间。综述表明，年龄、体重指数（BMI）、病程和AN的亚型与硫胺素状态无关。有限的现有证据表明，补充剂的使用、先前的治疗和较高的能量摄入与AN患者硫胺素缺乏症发生风险的降低有关。研究方法不佳（包括样本量小、缺乏一致的缺乏症定义和研究异质性）限制了所能得出的结论。最终，证据强度不足以得出明确的临床建议。本综述强调需要采用更可靠方法进行进一步研究，以帮助为临床实践提供更多信息。
