Rog Joanna, Karakuła Kaja, Rząd Zuzanna, Niedziałek-Serafin Karolina, Juchnowicz Dariusz, Rymuszka Anna, Karakula-Juchnowicz Hanna
I Department of Psychiatry, Psychotherapy and Early Intervention in Lublin, Medical University of Lublin, 20-059 Lublin, Poland.
Department of Psychiatry and Psychiatric Nursing, Medical University of Lublin, 20-059 Lublin, Poland.
Nutrients. 2025 Jul 9;17(14):2260. doi: 10.3390/nu17142260.
: Anorexia nervosa (AN) is a chronic eating disorder with the highest mortality rate among psychiatric conditions. Malnutrition and starvation lead to long-term impairments in metabolic processes, hormonal regulation, and immune function, offering potential diagnostic and prognostic value. This study aimed to identify immune-metabolic-hormonal markers associated with treatment response and nutritional rehabilitation. : Fifty hospitalized female patients with AN were included. Anthropometric measurements and venous blood samples were collected at admission and discharge, following partial nutritional recovery. Blood analyses included complete blood count, serum levels of total cholesterol, LDL and HDL, triglycerides, glucose, NT-pro-BNP, TSH, free thyroxine (fT4), sodium, chloride, potassium, calcium, iron, and vitamin D. Composite immune-inflammatory indices calculated were neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR); neutrophil-to-high-density lipoprotein (NHR), monocyte-to-high-density lipoprotein (MHR), platelet-to-high-density lipoprotein (PHR) and lymphocyte-to-high-density lipoprotein (LHR) ratios; systemic immune-inflammation (SII), and systemic inflammation response (SIRI) indexes. : Responders (R) and non-responders (NR) differed significantly at baseline in levels of sodium, chloride, fT4, monocyte count, MCV, NLR, MLR, SII, and SIRI (all: R < NR; < 0.05). Predictive ability for treatment response was confirmed by AUC values (95%CI): sodium = 0.791 (0.622-0.960), chloride = 0.820 (0.690-0.950), fT4 = 0.781 (0.591-0.972), monocytes = 0.785 (0.643-0.927), MCV = 0.721 (0.549-0.892), NLR = 0.745 (0.578-0.913), MLR = 0.785 (0.643-0.927), SII = 0.736 (0.562-0.911), SIRI = 0.803 (0.671-0.935). The lower levels of inflammation and chloride are particularly predictive of better nutritional recovery, accounting for 26% of the variability in treatment response. : The study demonstrated important insights into the hematological, metabolic, hormonal, and immune-inflammatory mechanisms associated with nutritional recovery in AN.
神经性厌食症（AN）是一种慢性进食障碍，在精神疾病中死亡率最高。营养不良和饥饿会导致代谢过程、激素调节和免疫功能的长期损害，具有潜在的诊断和预后价值。本研究旨在确定与治疗反应和营养康复相关的免疫-代谢-激素标志物。
纳入了50名住院的AN女性患者。在入院时和部分营养恢复后的出院时进行人体测量并采集静脉血样。血液分析包括全血细胞计数、血清总胆固醇、低密度脂蛋白和高密度脂蛋白、甘油三酯、葡萄糖、N末端脑钠肽前体（NT-pro-BNP）、促甲状腺激素（TSH）、游离甲状腺素（fT4）、钠、氯、钾、钙、铁和维生素D水平。计算的综合免疫炎症指标包括中性粒细胞与淋巴细胞比值（NLR）、单核细胞与淋巴细胞比值（MLR）、血小板与淋巴细胞比值（PLR）；中性粒细胞与高密度脂蛋白比值（NHR）、单核细胞与高密度脂蛋白比值（MHR）、血小板与高密度脂蛋白比值（PHR）和淋巴细胞与高密度脂蛋白比值（LHR）；全身免疫炎症（SII）和全身炎症反应（SIRI）指数。
反应者（R）和无反应者（NR）在基线时钠、氯、fT4、单核细胞计数、平均红细胞体积（MCV）、NLR、MLR、SII和SIRI水平存在显著差异（均为：R < NR；P < 0.05）。AUC值（95%置信区间）证实了对治疗反应的预测能力：钠 =
0.791（0.622 - 0.960），氯 = 0.820（0.690 - 0.950），fT4 = 0.781（0.591 - 0.972），单核细胞 = 0.785（0.643 - 0.927），MCV = 0.721（0.549 - 0.892），NLR = 0.745（0.578 - 0.913），MLR = 0.785（0.643 - 0.927），SII = 0.736（0.562 - 0.911），SIRI = 0.803（0.671 - 0.935）。较低的炎症水平和氯水平尤其可预测更好的营养恢复情况，占治疗反应变异性的26%。
该研究对与AN营养恢复相关的血液学、代谢、激素和免疫炎症机制提供了重要见解。
