Original ArticleAssociations of Elevated Liver Enzymes among Hospitalized Adolescents with Anorexia Nervosa
Section snippets
Methods
Criteria for study eligibility included adolescents ages 10-22 years with AN admitted to the inpatient eating disorders unit at Lucile Packard Children's Hospital at Stanford between January 2007 and December 2012 for medical stabilization. Criteria for admission included one or more of the following: severe malnutrition (<75% median BMI [mBMI]), heart rate <50 beats per minute during the day or 45 beats per minute at night, hypotension <90/45 mm Hg, orthostatic changes in pulse and blood
Results
Overall, 356 subjects met eligibility criteria between 2007 and 2012 and were included in the study (Table I). They were predominantly female (89.0%) and non-Hispanic white (72.2%), but included a sizeable percentage of Hispanic (12.6%) and Asian (11.5%) subjects. Mean age was 16.1 ± 2.4 years. Average duration of illness was 1.1 years and average rate of weight loss was 1.7 kg per month before admission. They were moderately malnourished (BMI 15.9 ± 1.9) and were restricting their calories to
Discussion
We report a 37.0% prevalence of elevated liver enzymes on first admission for AN, with an additional 4.1% of patients who developed elevated liver enzymes after admission. Male sex and more severe degree of malnutrition, measured by %mBMI, were significantly associated with odds of having elevated liver enzymes on admission. However, greater initial prescribed calories were associated with odds of having elevated liver enzymes after admission, indicating a possible contribution of refeeding. On
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The authors declare no conflicts of interest.