ESPEN 2020 Abstract Submission
Topic: Nutritional assessment
Abstract Submission Identifier: ESPEN20-ABS-1247
MICRONUTRIENT STATUS IN CHILDREN WITH ANOREXIA NERVOSA: HIGH FREQUENCY OF EARLY COPPER AND SELENIUM DEFICIENCIES
Z. Iordan*, 1, P. Poinsot 1, 2, 3, S. Iceta 1, 3, 4, D. Morfin 1, J. Berthiller 5, P. Fourneret 1, A. Alcaraz 1, B. Segrestin 1, 6, N. Peretti 1, 2, 3
1Rhone, Referral Center for Eating Disorders, Hospices Civils de Lyon, 2Rhone, Departement of Pediatric Nutrition, Hôpital Femme Mère Enfant, Bron, 3Rhone, CarMeN Laboratory, INSERM, INRA, INSA Lyon, Université Claude Bernard Lyon 1, Pierre-Benite, France, 4Institut universitaire de cardiologie et de pneumologie de Québec , Quebec, Canada, 5Rhone, Epidemiological and Clinical Research Unit. Public Health Department, Hospices Civils de Lyon, Bron, 6CRNH Rhône-Alpes, Hospices Civils de Lyon, CENS, Centre de Recherche en Nutrition Humaine Rhône-Alpes, Pierre-Benite, France
Rationale: Anorexia nervosa (AN) is a serious psychiatric disease with a high morbidity. The incidence of AN before and during puberty exposes children to poor growth, developmental delay and major nutritional deficiencies. Recently, the prevalence of micronutrient deficiencies in adults with AN have been described in two large cohorts. Despite an important role of micronutrients in adolescent development, there are no data on the micronutrient status of children with AN. The aim of this study was to provide a comprehensive description of micronutrient status in a pediatric AN population depending on the type of AN – AN-restrictive (AN-R) vs AN-binge eating/purging (AN-BP).
Methods: This retrospective study included patients less than 18 years old, followed for AN-R or AN-BP, at a referral center for eating disorders from January 2016 to May 2017. All female patients under 18 years old with a diagnosis of AN according to the Diagnostic Statistical Manual of Mental disorders (DSM-V and consulting for the first time at the center were included. All patients included had a nutritional assessment including measurement of copper, zinc and selenium plasma levels.
Results: Eighty four patients were evaluated in our cohort. Copper and selenium deficiencies were the most prevalent deficient micronutrients, with an occurrence of 78% and 17.3% respectively. Micronutrient deficiencies occurred despite a short median AN history of 8.7 months. There was no difference in the incidence of micronutrient deficiencies between the restrictive and the binge-eating/purging type of AN.
Table 1. Comparison of micronutrient status between AN-R and AN-BP Subgroups |
| |||||||
|
|
|
AN-R |
(n) |
SD |
AN-BP |
(n) |
SD |
p |
|
Ferritin |
(µg/L) |
131 |
65 |
73.1 |
57.9 |
16 |
49.5 |
NS |
|
Selenium |
(µg/L) |
83.1 |
66 |
13.2 |
77.1 |
15 |
12.4 |
NS |
|
Copper |
(mg/L) |
0.7 |
27 |
0.2 |
0.9 |
5 |
0.2 |
NS |
|
Zinc |
(mg/L) |
0.8 |
65 |
0.2 |
0.8 |
15 |
0.1 |
NS |
|
Vitamin B1 |
(nmol/L) |
114.1 |
66 |
26 |
120.3 |
14 |
22.3 |
NS |
|
Vitamin B6 |
(nmol/L) |
83.4 |
24 |
29.2 |
101.3 |
3 |
51.6 |
NS |
|
Vitamin B12 |
(nmol/L) |
515.4 |
66 |
220.5 |
794.8 |
15 |
1184.2 |
NS |
|
Vitamin B9 |
(nmol/L) |
6.6 |
66 |
3.1 |
5.7 |
15 |
3.1 |
NS |
|
Vitamin D |
(nmol/L) |
76.9 |
64 |
21 |
68.1 |
15 |
18.7 |
NS |
Conclusion: The incidence and precocity of micronutrient deficiencies in the pediatric population suffering from AN was high. Micronutrient screening should be part of the initial evaluation of children with AN. The clinical consequences of such deficiencies should be evaluated in a larger prospective cohort.
References: Hanachi M, Dicembre M, Rives-Lange C, Ropers J, Bemer P, Zazzo J-F, et al. Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients. Nutrients. 5 avr 2019;11(4).
Achamrah N, Coëffier M, Rimbert A, Charles J, Folope V, Petit A, et al. Micronutrient Status in 153 Patients with Anorexia Nervosa. Nutrients. 02 2017;9(3).
Disclosure of Interest: None Declared
Keywords: Anorexia nervosa, Micronutrients