Helen Burton-Murray, Aluma Chovel Sella, Julia E. Gydus, Micaela Atkins, Lilian P. Palmer, Megan C. Kuhnle, Kendra R. Becker, Lauren E. Breithaupt, Kathryn S. Brigham, Anna Aulinas, Kyle Staller, Kamryn T. Eddy, Madhusmita Misra, Nadia Micali, Jennifer J. Thomas, Elizabeth A. Lawson
Objective
Avoidant/restrictive food intake disorder (ARFID) is common among populations with nutrition-related medical conditions. Less is known about the medical comorbidity/complication frequencies in youth with ARFID. We evaluated the medical comorbidities and metabolic/nutritional markers among female and male youth with full/subthreshold ARFID across the weight spectrum compared with healthy controls (HC).
Method
In youth with full/subthreshold ARFID (n = 100; 49% female) and HC (n = 58; 78% female), we assessed self-reported medical comorbidities via clinician interview and explored abnormalities in metabolic (lipid panel and high-sensitive C-reactive protein [hs-CRP]) and nutritional (25[OH] vitamin D, vitamin B12, and folate) markers.
Results
Youth with ARFID, compared with HC, were over 10 times as likely to have self-reported gastrointestinal conditions (37% vs. 3%; OR = 21.2; 95% CI = 6.2–112.1) and over two times as likely to have self-reported immune-mediated conditions (42% vs. 24%; OR = 2.3; 95% CI = 1.1–4.9). ARFID, compared with HC, had a four to five times higher frequency of elevated triglycerides (28% vs. 12%; OR = 4.0; 95% CI = 1.7–10.5) and hs-CRP (17% vs. 4%; OR = 5.0; 95% CI = 1.4–27.0) levels.
Discussion
Self-reported gastrointestinal and certain immune comorbidities were common in ARFID, suggestive of possible bidirectional risk/maintenance factors. Elevated cardiovascular risk markers in ARFID may be a consequence of limited dietary variety marked by high carbohydrate and sugar intake.
目的：避免/限制性食物摄入障碍（ARFID）在患有营养相关疾病的人群中很常见。但人们对患有 ARFID 的青少年的合并症/并发症频率知之甚少。与健康对照组（HC）相比，我们评估了在体重范围内患有完全/次阈值ARFID的男女青少年的医疗合并症和代谢/营养指标：在患有完全/次阈值ARFID的青少年（n = 100；49%为女性）和健康对照组（n = 58；78%为女性）中，我们通过临床医生访谈评估了自我报告的医疗合并症，并探讨了代谢（血脂组合和高敏C反应蛋白[hs-CRP]）和营养（25[OH]维生素D、维生素B12和叶酸）指标的异常：与白血病患者相比，患有 ARFID 的青少年自我报告患有胃肠道疾病的几率是白血病患者的 10 倍以上（37% 对 3%；OR = 21.2；95% CI = 6.2-112.1），自我报告患有免疫介导疾病的几率是白血病患者的 2 倍以上（42% 对 24%；OR = 2.3；95% CI = 1.1-4.9）。ARFID与HC相比，甘油三酯（28% vs. 12%；OR = 4.0；95% CI = 1.7-10.5）和hs-CRP（17% vs. 4%；OR = 5.0；95% CI = 1.4-27.0）水平升高的频率高出4-5倍：讨论：自我报告的胃肠道和某些免疫合并症在ARFID中很常见，这表明可能存在双向的风险/维持因素。ARFID患者的心血管风险指标升高可能是饮食种类有限的结果，其特点是碳水化合物和糖的摄入量较高。
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