Auger Nathalie, Israël Mimi, Steiger Howard, Low Nancy, Chadi Nicholas, Brousseau Émilie, Ayoub Aimina, Côté-Corriveau Gabriel
University of Montreal Hospital Research Centre, Montreal, Canada.
Institut national de santé publique du Québec, Montreal, Canada.
Int J Eat Disord. 2025 Jul;58(7):1256-1264. doi: 10.1002/eat.24435. Epub 2025 Apr 2.
To determine the extent to which anorexia nervosa is associated with premature mortality.
We carried out a matched cohort study of 7332 male and female patients with anorexia nervosa and 73,215 patient controls who were admitted between 1989 and 2023 in hospital centers of Quebec, Canada. We tracked the patients longitudinally over time to identify premature deaths before age 75 years and determined the cause of death. We used stratified Cox regression models adjusted for patient characteristics to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the association between anorexia nervosa and premature mortality.
Overall, 186 (2.5%) patients with anorexia nervosa and 615 (0.8%) matched controls died before age 75 years. Compared with no anorexia, anorexia nervosa was associated with 3.02 times the risk of premature mortality among females (95% CI 2.50-3.65) and 2.23 times the risk among males (95% CI 1.35-3.70). Patients with a first anorexia nervosa admission between age 20 and 29 years were most at risk of premature mortality (HR 8.00, 95% CI 4.30-14.88), as were patients hospitalized ≥ 3 times for anorexia nervosa (HR 4.72, 95% CI 3.25-6.84). Anorexia nervosa was associated with premature mortality due to metabolic and other endocrine disorders, suicide, and a range of other causes.
Anorexia nervosa is associated with an elevated risk of premature mortality from metabolic disorders, suicide, and other causes. Patients who are female, hospitalized as young adults, or have repeated admissions for anorexia nervosa are most at risk.
确定神经性厌食症与过早死亡的关联程度。
我们对7332例神经性厌食症的男性和女性患者以及73215例对照患者进行了匹配队列研究，这些患者于1989年至2023年期间在加拿大魁北克的医院中心入院。我们对患者进行长期跟踪，以确定75岁之前的过早死亡情况，并确定死亡原因。我们使用针对患者特征进行调整的分层Cox回归模型来估计神经性厌食症与过早死亡之间关联的风险比（HR）和95%置信区间（CI）。
总体而言，186例（2.5%）神经性厌食症患者和615例（0.8%）匹配的对照患者在75岁之前死亡。与无神经性厌食症相比，神经性厌食症在女性中与过早死亡风险高3.02倍相关（95%CI 2.50 - 3.65），在男性中与过早死亡风险高2.23倍相关（95%CI 1.35 - 3.70）。首次因神经性厌食症入院年龄在20至29岁之间的患者过早死亡风险最高（HR 8.00，95%CI 4.30 - 14.88），因神经性厌食症住院≥3次的患者也是如此（HR 4.72，95%CI 3.25 - 6.84）。神经性厌食症与因代谢和其他内分泌紊乱、自杀及一系列其他原因导致的过早死亡相关。
神经性厌食症与因代谢紊乱（如自杀和其他原因）导致的过早死亡风险升高相关。女性患者、年轻时住院的患者或因神经性厌食症反复入院的患者风险最高。
