Leah Puckett, Amy Stein, Marina Kelley, Philip S. Mehler
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引用次数: 0
摘要
目的：低血糖会导致严重进食障碍患者严重发病和死亡。我们使用血红蛋白 A1C（HbA1C）测量了因极度神经性厌食症（AN）和回避性限制性食物摄入障碍（ARFID）住院患者的平均血糖水平：这是一项在住院医疗稳定病房进行的前瞻性单中心队列研究。临床结果采用配对 t 检验进行比较。使用双样本 t 检验对检测不到 HbA1c 和检测到 HbA1c 之间的临床变量进行比较：研究对象共有 148 人，90% 为女性，平均年龄 31 岁，平均体重指数为 12.5 kg/m2，平均理想体重百分比为 60.1%。诊断结果包括限制性厌食症（54%）、厌食症-暴饮暴食（39%）和ARFID（7%）。HbA1C 和果糖胺水平从入院到出院均有所下降。从入院到出院，血清葡萄糖水平明显升高。入院时平均 HbA1C 为 4.7%，出院时为 4.3%：本研究使用 HbA1C 评估了极端 AN 和 ARFID 患者的平均血糖水平。考虑到低血糖症在这类人群中的发病率和死亡率问题（单次护理点血糖测量可能会忽略低血糖症），HbA1C 是测量极端形式进食障碍患者血糖状况的重要实验室指标。
Evaluation of Mean Plasma Glucose Levels Using HbA1C in Patients With Severe Eating Disorders
Objective
Hypoglycemia causes significant morbidity and mortality in patients with severe eating disorders. We measured average glycemic levels using hemoglobin A1C (HbA1C) in patients hospitalized for extreme anorexia nervosa (AN) and avoidant restrictive food intake disorder (ARFID).
Methods
This was a prospective, single-center cohort study conducted in an inpatient medical stabilization unit. Clinical outcomes were compared using paired t-tests. Additional analysis comparing clinical variables between undetectable and detectable HbA1c used two-sample t-tests.
Results
The study cohort consisted of 148 individuals, 90% female, average age of 31 years, average admit body mass index of 12.5 kg/m2, and mean percentage ideal body weight of 60.1%. Diagnoses included AN-restricting (54%), AN-binge purge (39%), and ARFID (7%). HbA1C and fructosamine levels decreased from admission to discharge. Serum glucose levels increased significantly from admission to discharge. Mean HbA1C was 4.7% on admission and 4.3% on discharge.
Discussion
This study evaluated mean blood glucose levels using HbA1C in patients with extreme forms of AN and ARFID. Given the concern for morbidity and mortality from hypoglycemia in this population, which can be overlooked on a single point-of-care glucose measurement, HbA1C is a valuable laboratory measure of glycemic status in patients with extreme forms of eating disorders.
期刊介绍：
Articles featured in the journal describe state-of-the-art scientific research on theory, methodology, etiology, clinical practice, and policy related to eating disorders, as well as contributions that facilitate scholarly critique and discussion of science and practice in the field. Theoretical and empirical work on obesity or healthy eating falls within the journal’s scope inasmuch as it facilitates the advancement of efforts to describe and understand, prevent, or treat eating disorders. IJED welcomes submissions from all regions of the world and representing all levels of inquiry (including basic science, clinical trials, implementation research, and dissemination studies), and across a full range of scientific methods, disciplines, and approaches.
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