Abstract :
Introduction: Eating disorders are major mental disorders that affect all aspects of life, including quality of life at home or workplace, personal functions, and social life. Malnutrition, particularly iron deficiency, can result from a lack of food intake caused by eating disorders.
Aim: This study aimed to determine the impact of eating disorders in adolescents on hematological alterations and iron serum indexes.
Method: The study was conducted by doing online database searches systematically using relevant search terms and appropriate criteria. Sources of literature that were traced were those published until 2022. The online searches were conducted on the following databases: MEDLINE, PubMed, PsycINFO, ScienceDirect, Scielo, and DynaMed Plus.
Results: Searching by keyword yielded 55 titles and abstracts. When they were screened, a total of 41 publications were saved for further analysis. However, only 8 publications met the inclusion criteria and were continued for review (two studies that used a cross-sectional design, one case-control study, and five cohort studies).
Conclusion: Iron deficiency and anemia were uncommon in young women who had eating disorders and weight loss. However, there was a rise in serum ferritin and serum hepcidin, as well as a decrease in transferrin, based on evaluations using biomarkers that were more sensitive for the detection of adolescent anorexia nervosa. In participants who gained weight after receiving nutritional therapy, transferrin levels increased whereas ferritin and hepcidin levels declined (rapid depletion).
Keywords :
Adolescence, Eating disorder, Hematology, Iron serum indexesReferences :
1 Hudson JI, Hiripi E, Pope HG, Kessler RC. 2007 The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. Biol Psychiatry. 61:348–58. https://doi.org/10.1016/j.biopsych.2006.03.040.
2 Steinhausen HC, Jakobsen H, Helenius D, Munk-Jørgensen P, Strober M. 2014 A nation-wide study of the family aggregation and risk factors in anorexia nervosa over three generations. Int J Eat Disord. 1–8. https://doi.org/10.1002/eat.22293.
3 Micali N, Stemann Larsen P, Strandberg-Larsen K, Nybo Andersen AM. 2015 Size at birth and preterm birth in women with lifetime eating disorders: a prospective population-based study. BJOG An Int J Obstet Gynaecol. 1301–10. https://doi.org/10.1111/1471-0528.13825.
4 Hoek HW. 2006 Incidence, prevalence and mortality of anorexia nervosa and other disorders. Curr Opin Psychiatry. 19:389–94. https://doi.org/10.1097/YCO.0000000000000739.
5 Nova E, Lopez-Vidriero I, Varela P, Toro O, Casas J, Marcos A. 2004 Indicators of nutritional status in restricting-type anorexia nervosa patients: A 1-year follow-up study. Clin Nutr. 23:1353–9. https://doi.org/10.1016/j.clnu.2004.05.004.
6 Bouis HE, Eozenou P, Rahman A. 2011 Food prices, household income, and resource allocation: Socioeconomic perspectives on their effects on dietary quality and nutritional status. Food Nutr Bull. 32:14–23. https://doi.org/10.1177/15648265110321s103.
7 Kennedy A, Kohn M, Lammi A, Clarke S. 2004 Iron status and haematological changes in adolescent female inpatients with anorexia nervosa. J Paediatr Child Health. 40:430–2. https://doi.org/10.1111/j.1440-1754.2004.00432.x.
8 Xia Y, Babitt JL, Sidis Y, Chung RT, Lin HY. 2008 Hemojuvelin regulates hepcidin expression via a selective subset of BMP ligands and receptors independently of neogenin. Blood. 111:5195–204. https://doi.org/10.1182/blood-2007-09-111567.
9 Chang YJ, Lin W, Wong Y. 2011 Survey on Eating Disorder–Related Thoughts, Behaviors, and Their Relationship with Food Intake and Nutritional Status in Female High School Students in Taiwan. J Am Coll Nutr. 30:39–48. https://doi.org/10.1080/07315724.2011.10719942.
10 Costa NF da, Schtscherbyna A, Soares EA, Ribeiro BG. 2013 Disordered eating among adolescent female swimmers: Dietary, biochemical, and body composition factors. Nutrition. 29:172–7. https://doi.org/10.1016/j.nut.2012.06.007.
11 Lumish RA, Young SL, Lee S, Cooper E, Pressman E, Guillet R, et al. 2014 Gestational Iron deficiency is associated with pica behaviors in adolescents. J Nutr. 144:1533–9. https://doi.org/10.3945/jn.114.192070.
12 Nemba K, Lewis B, Watson H, Hoiles K, Zhang G, Forbes D. 2014 Serum ferritin and nutritional status: Insights from an eating disorders clinic population. Arch Dis Child. 99:221–4. https://doi.org/10.1136/archdischild-2012-303272.
13 Papillard-Marechal S, Sznajder M, Hurtado-Nedelec M, Alibay Y, Martin-Schmitt C, Dehoux M, et al. 2012 Iron metabolism in patients with anorexia nervosa: Elevated serum hepcidin concentrations in the absence of inflammation. Am J Clin Nutr. 95:548–54. https://doi.org/10.3945/ajcn.111.025817.
14 Swenne I. 2007 Haematological changes and iron status in teenage girls with eating disorders and weight loss – The importance of menstrual status. Acta Paediatr Int J Paediatr. 96:530–3. https://doi.org/10.1111/j.1651-2227.2007.00172.x.
15 Grantham-McGregor S, Ani C. 2001 Iron-deficiency anemia: reexamining the nature and magnitude of the public health problem. J Nutr. 649–68.
16 Evstatiev R, Gasche C. 2012 Iron sensing and signalling. Gut. 61:933–52. https://doi.org/10.1136/gut.2010.214312.
17 Finch CA, Bellotti V, Stray S, Lipschitz DA, Cook JD, Pippard MJ, et al. 1986 Plasma ferritin determination as a diagnostic tool. West J Med. 145:657–63.
18 Vidnes A, Opstad PK. 1981 Serum Ferritin in Young Men during Prolonged Heavy Physical Exercise. Scand J Haematol 27:165–70. https://doi.org/10.1111/j.1600-0609.1981.tb00468.x.
19 Samuelson G, Lönnerdal B, Kempe B, Elverby JE, Bratteby LE. 2003 Serum ferritin and transferrin receptor concentrations during the transition from adolescence to adulthood in a healthy Swedish population. Acta Paediatr Int J Paediatr. 92:5–11. https://doi.org/10.1111/j.1651-2227.2003.tb00460.x.
20 Lundberg P, Lindstedt G, Andersson T, Branegard B, Lundquister G, Nystrom E. 1984 Increase in serum ferritin concentration induced by fasting. Clin Chem. 30:161–3.
21 Domenico I De, Ward DM, Langelier C, Vaughn MB, Nemeth E, Sundquist WI, et al. 2007 The Molecular Mechanism of Hepcidin-mediated Ferroportin Down-Regulation. Mol Biol Cell. 18:2569–78. https://doi.org/10.1091/mbc.E07.
22 Hentze MW, Muckenthaler MU, Galy B, Camaschella C. 2010 Two to Tango: Regulation of Mammalian Iron Metabolism. Cell 142:24–38. https://doi.org/10.1016/j.cell.2010.06.028.