重症神经性厌食症患者血浆白蛋白的研究

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-28 DOI:10.1016/j.clnesp.2025.07.1120

Jeanie Meincke Egedal , Gry Sørdal Lorentzen , Magnus Sjögren , Georgios Paslakis , René Klinkby Støving

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引用次数: 0

摘要

目的：神经性厌食症是一种以慢性营养不良为特征的疾病。本研究旨在确定医学上不稳定的严重AN患者低白蛋白血症的频率及其与炎症和死亡率的关系。方法：从2017年至2021年丹麦一家专业医疗单位收治的患者的电子健康记录中收集数据。总共登记了159项记录，其中127项符合纳入标准。分析两组患者的临床特点、实验室指标及生命体征。根据血浆白蛋白（PA）水平将患者分为低白蛋白血症组（50 g/L）。采用welch t检验、Fisher精确检验和多变量logistic回归进行统计分析，以评估白蛋白状态与死亡率之间的关系，调整BMI和疾病持续时间。结果：78.6%的患者表现为正常白蛋白血症，7.1%为低白蛋白血症，14.3%为高白蛋白血症。低蛋白血症组平均体温升高（p=0.041），平均血小板计数升高（p=0.046），平均血红蛋白水平降低（p=0.046）。在2017-2021年期间，低白蛋白血症组的死亡率明显更高，有4人（44%）死亡，而正常白蛋白血症组的死亡率为5人（5.1%）（p=0.012），两组之间的年龄差异无统计学意义（p=0.067）。Logistic回归显示，低白蛋白血症组的死亡风险显著增加（OR = 6.39, p = 0.038）。讨论：尽管病情严重，大多数AN患者维持正常的PA水平，可能是由于适应性生理机制。PA水平评估有助于识别高危患者，因为低白蛋白血症与炎症和死亡率增加有关。结论：尽管有显著的营养限制，即使是严重和极端AN患者也能维持正常的PA水平。低白蛋白血症与死亡率增加有关。

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Plasma albumin in patients with severe anorexia nervosa admitted to a specialized medical unit

Objective

Anorexia nervosa (AN) is a condition characterized by chronic malnutrition. This study aims to determine the frequency of hypoalbuminemia in individuals with severe, medical unstable AN and its associations with inflammation and mortality.

Method

Data were collected from electronic health records on patients admitted to a specialized, medical unit in Denmark between 2017 and 2021. A total of 159 records were initially registered, with 127 meeting the inclusion criteria. Clinical characteristics, laboratory values and vital signs were analyzed. Patients were divided into groups based on their plasma albumin (PA) levels, being hypoalbuminemic (<36 g/L), normoalbuminemic (36–50 g/L), and hyperalbuminemic (>50 g/L), respectively. Statistical analyses were made using Welches t-test, Fisher's exact and a multivariable logistic regression was performed to assess the association between albumin status and mortality, adjusting for BMI and illness duration.

Results

78.6 % of patients exhibited normoalbuminemia, 7.1 % were hypoalbuminemic, and 14.3 % were hyperalbuminemic. The hypoalbuminemic group had higher mean body temperature (p = 0.041), higher mean platelet count (p = 0.046), and a lower mean hemoglobin level (p = 0.046). Mortality was strikingly higher in the hypoalbuminemic group with 4 (44 %) deceased, compared to 5 (5.1 %) in the normoalbuminemic group (p = 0.012) during the 2017–2021 period, with no statistically significant difference in age between the two groups (p = 0.067). Logistic regression revealed a significantly increased risk of death in the hypoalbuminemic group (OR = 6.39, p = 0.038).

Discussion

Despite the severity of the illness, most patients with AN maintained normal PA levels, probably due to adaptive physiological mechanisms. PA level assessments could aid in identifying high-risk patients, as hypoalbuminemia was associated with inflammation and increased mortality.

Conclusion

Despite significant nutritional restrictions, even individuals with severe and extreme AN maintain normal PA levels. Hypoalbuminemia was associated with increased mortality.

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.