Tarchi Livio, Cassioli Emanuele, Rossi Eleonora, Faldi Marco, D'Areglia Eleonora, Maiolini Gaia, Nannoni Anita, Scheggi Valentina, Alterini Brunetto, Ricca Valdo, Castellini Giovanni
Psychiatry Unit, Department of Health Sciences, University of Florence, AOU Florence, 50134, Italy.
Dietetics Unit, Careggi University Hospital, Florence, 50134, Italy.
Nutr Metab Cardiovasc Dis. 2025 Feb;35(2):103728. doi: 10.1016/j.numecd.2024.08.021. Epub 2024 Sep 5.
Predictors of outcomes are needed in order to improve the clinical management of patients with Anorexia Nervosa (AN). The present study evaluated whether cardiac dysfunction might be associated with different longitudinal outcomes of AN.
A sample of 35 patients with AN (11 restricting, 24 binge-purging- age range 16-28 years old) and 42 healthy controls (18-29 years old) were evaluated in terms of psychometric variables, Body Mass Index (BMI), body composition (by bioimpedance analysis, namely: Fat-Free Mass - FFM, Fat Mass - FM, Body Cell Mass - BCM, Phase Angle - PhA) and cardiac functioning (left ventricular ejection fraction - LVEF; global longitudinal strain - LVGLS). FM was significantly and negatively associated with eating psychopathology (weight and shape concerns, b -0.523, p 0.029; and shape concerns b -0.578, p0.015), while cardiac dysfunction (LVGLS > -18%) was positively associated with dietary restraints (b 1.253, p 0.043). LVEF, in turn, was positively associated with BCM (b 0.721, p 0.008) and FFM (b 0.779, p 0.039). Cardiac dysfunction negatively impacted the effect of nutritional rehabilitation, as those patients reporting reduced LVGLS showed lower FFM (b -4.410, p 0.011), FM (b -1.495, p 0.003) and BCM (b -2.205, p 0.015) at follow-up after three months.
These preliminary results showed that cardiac functioning might represent an early predictor of cachexia and chronicity, while body composition seems to be a more accurate measure for evaluating the recovery process of patients with AN.
为改善神经性厌食症（AN）患者的临床管理，需要了解其预后的预测因素。本研究评估了心脏功能障碍是否可能与AN的不同纵向预后相关。
对35例AN患者（11例节食型，24例暴饮暴食-清除型，年龄范围16 - 28岁）和42名健康对照者（18 - 29岁）进行了心理测量变量、体重指数（BMI）、身体成分（通过生物电阻抗分析，即：去脂体重 - FFM、脂肪量 - FM、体细胞量 - BCM、相位角 - PhA）和心脏功能（左心室射血分数 - LVEF；整体纵向应变 - LVGLS）方面的评估。FM与饮食心理病理学显著负相关（对体重和体型的关注，b -0.523，p 0.029；对体型的关注，b -0.578，p 0.015），而心脏功能障碍（LVGLS > -18%）与饮食限制正相关（b 1.253，p 0.043）。反过来，LVEF与BCM（b 0.721，p 0.008）和FFM（b 0.779，p 0.039）正相关。心脏功能障碍对营养康复效果有负面影响，因为那些LVGLS降低的患者在三个月后的随访中显示出较低的FFM（b -4.410，p 0.011）、FM（b -1.495, p 0.003）和BCM（b -2.205，p 0.015）。
这些初步结果表明，心脏功能可能是恶病质和慢性病程的早期预测指标，而身体成分似乎是评估AN患者康复过程更准确的指标。
