Ozawa Y, Shimizu T, Shishiba Y
Department of Endocrinology and Metabolism, Toranomon Hospital, Tokyo.
Intern Med. 1998 Jan;37(1):32-9. doi: 10.2169/internalmedicine.37.32.
To clarify the clinical significance of elevation of serum aminotransferase levels in anorexia nervosa, we analyzed the relationships of serum aminotransferase levels to other serum biochemistry and physical conditions before and during refeeding therapy in 101 patients with anorexia nervosa. Before refeeding therapy, body mass index (BMI) was distributed from 9.9 to 16.4 kg/m2 (13.2 +/- 1.3, mean +/- SD), and 29 patients (28.7%) showed abnormally high aminotransferase levels. Among 17 patients with a BMI of less than 12 kg/m2, the aminotransferase level was abnormally high in 13 patients (76%). Incidence and severity of serum aminotransferase elevation were greater in the patients with lower BMI. The groups with high serum aminotransferase levels had a lower body temperature, lower pulse rate, and higher incidence of other biochemical abnormalities than the group with normal serum aminotransferase levels. These findings indicate that aminotransferase elevation develops at a high incidence in anorectic patients with a critically life-threatening condition, and it is a sign of multiorgan failure requiring urgent calorie repletion. This type of aminotransferase elevation is to be distinguished from refeeding-induced aminotransferase elevation.
为阐明神经性厌食症患者血清转氨酶水平升高的临床意义，我们分析了101例神经性厌食症患者在重新进食治疗前及治疗期间血清转氨酶水平与其他血清生化指标和身体状况之间的关系。在重新进食治疗前，体重指数（BMI）范围为9.9至16.4kg/m²（13.2±1.3，平均值±标准差），29例患者（28.7%）转氨酶水平异常升高。在BMI低于12kg/m²的17例患者中，13例（76%）转氨酶水平异常升高。BMI较低的患者血清转氨酶升高的发生率和严重程度更高。血清转氨酶水平高的组比血清转氨酶水平正常的组体温更低、脉搏率更低，其他生化异常的发生率更高。这些发现表明，在患有危及生命的严重疾病的厌食症患者中，转氨酶升高的发生率很高，它是需要紧急补充热量的多器官功能衰竭的一个迹象。这种类型的转氨酶升高应与重新进食引起的转氨酶升高相区分。
