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Altered energy metabolism in anorexia nervosa

Identifieur interne : 000267 ( Main/Curation ); précédent : 000266; suivant : 000268

Altered energy metabolism in anorexia nervosa

Auteurs : Janice Russell [Australie] ; Louise A. Baur [Australie] ; Peter J. V Beumont [Australie] ; Suzanne Byrnes [Australie] ; Gaby Gross [Australie] ; Stephen Touyz [Australie] ; Suzanne Abraham [Australie] ; Stephan Zipfel [Allemagne]

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RBID : ISTEX:46BF689F1CC2FD87128B8F68154F2FD30DA5A553

Abstract

Optimal nutritional rehabilitation of anorexia nervosa requires more information concerning actual energy and substrate requirements. To this end, indirect calorimetry was performed in female patients (n=34, age 20.9±1.2 yr, body mass index [BMI] 15.6±0.2 kg/m2; mean±SEM) soon after commencement of refeeding and at the time of discharge from hospital (n=18, BMI 19.0±0.3 kg/m2). Healthy female controls (n=18, age 24.6±1.3 yr, BMI 21.6±0.6 kg/m2) were also tested. Resting energy expenditure (REE) and respiratory quotient (RQ) were measured in the fasting state, followed by diet-induced thermogenesis (DIT) and RQ over a 4 h period following a 100 g oral glucose load. Compared with post-refeeding patients and controls, pre-refeeding patients had a high basal RQ and a low REE, with a paradoxically higher DIT (13.2±0.9% of REE vs 8.3±1.2% and 8.6±0.9% in post-refeeding patients and controls, respectively). RQ values in pre-refeeding patients exceeded unity following the glucose load, probably reflecting net lipogenesis, whereas in the post-refeeding patients, post-glucose RQ was similar to that of controls, suggesting premature curtailment of lipogenesis. These data demonstrate energy wasting in emaciated patients with anorexia nervosa. Biological repair processes could account for disproportionate energy loss early in refeeding and there may be some later impediment to full restoration of fat stores.

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DOI: 10.1016/S0306-4530(00)00036-6

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ISTEX:46BF689F1CC2FD87128B8F68154F2FD30DA5A553

Le document en format XML

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<div type="abstract" xml:lang="en">Optimal nutritional rehabilitation of anorexia nervosa requires more information concerning actual energy and substrate requirements. To this end, indirect calorimetry was performed in female patients (n=34, age 20.9±1.2 yr, body mass index [BMI] 15.6±0.2 kg/m2; mean±SEM) soon after commencement of refeeding and at the time of discharge from hospital (n=18, BMI 19.0±0.3 kg/m2). Healthy female controls (n=18, age 24.6±1.3 yr, BMI 21.6±0.6 kg/m2) were also tested. Resting energy expenditure (REE) and respiratory quotient (RQ) were measured in the fasting state, followed by diet-induced thermogenesis (DIT) and RQ over a 4 h period following a 100 g oral glucose load. Compared with post-refeeding patients and controls, pre-refeeding patients had a high basal RQ and a low REE, with a paradoxically higher DIT (13.2±0.9% of REE vs 8.3±1.2% and 8.6±0.9% in post-refeeding patients and controls, respectively). RQ values in pre-refeeding patients exceeded unity following the glucose load, probably reflecting net lipogenesis, whereas in the post-refeeding patients, post-glucose RQ was similar to that of controls, suggesting premature curtailment of lipogenesis. These data demonstrate energy wasting in emaciated patients with anorexia nervosa. Biological repair processes could account for disproportionate energy loss early in refeeding and there may be some later impediment to full restoration of fat stores.</div>
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