Abstract
BackgroundThe objective of the study was to determine whether levels of biochemical and haematological parameters in patients with eating disorders (EDs) varied from the general population. Whilst dietary restrictions can lead to nutritional deficiencies, specific abnormalities may be relevant to the diagnosis, pathogenesis and treatment of EDs.MethodsWith ethics approval and informed consent, a retrospective chart audit was conducted of 113 patients with EDs at a general practice in Brisbane, Australia. This was analysed first as a total group (TG) and then in 4 ED subgroups: Anorexia nervosa (AN), Bulimia nervosa (BN), ED Not Otherwise Specified (EDNOS), and AN/BN. Eighteen parameters were assessed at or near first presentation: cholesterol, folate, vitamin B12, magnesium, manganese, zinc, calcium, potassium, urate, sodium, albumin, phosphate, ferritin, vitamin D, white cell count, neutrophils, red cell count and platelets. Results were analysed using IBM SPSS 21 and Microsoft Excel 2013 by two-tailed, one-sample t-tests (TG and 4 subgroups) and chi-square tests (TG only) and compared to the population mean standards. Results for the TG and each subgroup individually were then compared with the known reference interval (RI).ResultsFor the total sample, t-tests showed significant differences for all parameters (p < 0.05) except cholesterol. Most parameters gave results below population levels, but folate, phosphate, albumin, calcium and vitamin B12 were above. More patients than expected were below the RI for most parameters in the TG and subgroups.ConclusionsAt diagnosis, in patients with EDs, there are often significant differences in multiple haematological and biochemical parameters. Early identification of these abnormalities may provide additional avenues of ED treatment through supplementation and dietary guidance, and may be used to reinforce negative impacts on health caused by the ED to the patient, their family and their treatment team (general practitioner, dietitian and mental health professionals). Study data would support routine measurement of a full blood count and electrolytes, phosphate, magnesium, liver function tests, ferritin, vitamin B12, red cell folate, vitamin D, manganese and zinc for all patients at first presentation with an ED.
Highlights
The objective of the study was to determine whether levels of biochemical and haematological parameters in patients with eating disorders (EDs) varied from the general population
Plain English summary There is a need for developing basic knowledge at the primary care level of abnormalities in blood tests found in patients suffering from eating disorders (EDs)
Means, Study mean (SD) and t-test significance levels for all total group (TG) parameters are given in Table 2 and Fig. 1, population means being taken as the midpoint of the reference intervals (RIs)
Summary
The objective of the study was to determine whether levels of biochemical and haematological parameters in patients with eating disorders (EDs) varied from the general population. Whilst dietary restrictions can lead to nutritional deficiencies, specific abnormalities may be relevant to the diagnosis, pathogenesis and treatment of EDs. There is limited information in the literature regarding abnormalities in measured biochemical and haematological parameters in patients with eating disorders (EDs) in the primary care setting [1]. There is limited information in the literature regarding abnormalities in measured biochemical and haematological parameters in patients with eating disorders (EDs) in the primary care setting [1] This retrospective study was undertaken to investigate whether levels of selected biochemical and haematological parameters in patients diagnosed with EDs were significantly different from the general population [2]. This study represents one of the larger study groups of patients with EDs but is unique in that it is from the ambulatory primary care setting as opposed to most published data which are derived from secondary or tertiary care facilities [3]
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