Cardiovascular risk at the extremes of body composition.

摘要

P revalence estimates for anorexia nervosa (AN) range from 0.1% to 1% in the general population, with an average prevalence of approximately 0.29% in girls. The mortality rate associated with this condition is high (5 9%-18%), and death is mainly attributed to cardiac events stemming from electrical abnormalities such as prolonged QT interval. Individuals with AN also demonstrate cardiac systolic and diastolic dysfunction and adverse myocardial remodeling. Many of these problems are corrected or improved with weight regain. The limited data that exist suggest that, similar to AN in adults, AN in adolescents is associated with cardiac structural (decreased left-ventricular mass and wall thickness), functional (diastolic dysfunction), and electrical (prolonged QT interval and bradycardia) abnormalities. Like in adults, in adolescents most of these abnormalities seem to be reversible or improved with re-feeding and weight regain.4"6 Little is known about the presence of the traditional risk factors for atherosclerotic cardiovascular disease in AN. Reports from the adult literature are mixed. Some studies show that AN is associated with lipid de-rangements and increased levels of inflammatory cytokines, and others show that these variables are not altered. There are currently no reports in the literature addressing this question in adolescents.