Anorexia nervosa (AN) is a complex disorder with specific somatic complications. Undernutrition is a key diagnostic criteria of AN. It can be associated with several micronutrients deficiencies.

A study recently assessed the prevalence of micronutrients deficiencies and compared the differences between the two subtypes of AN - restricting type (AN-R) and binge-eating/purging type (AN-BP).

This large retrospective, monocentric study included patients hospitalized in a highly specialized nutrition unit from January 2011 to August 2017 for severe malnutrition treatment in the context of AN.

Overall, 374 patients, including 360 (96%) women and 14 (4%) men, age: 31.3 ± 12.9 years, Body Mass Index (BMI) 12.5 ± 1.7 kg/m² were included in the study. About 68% of the patients had AN-R subtype while 32% had AN-BP. The highest deficiency prevalence was for zinc (64.3%), followed by vitamin D (54.2%), copper (37.1%), selenium (20.5%), vitamin B1 (15%), vitamin B12 (4.7%), and vitamin B9 (8.9%).

Patients with AN-BP type presented with longer disease duration, were older, and had a lower left ventricular ejection fraction (LVEF) in comparison with AN-R type patients, who had significantly higher alanine aminotransferase (ALT) and brain natriuretic peptide (BNP) levels. The AN-BP group, in comparison with the AN-R group, had lower selenium and vitamin B12 plasma concentration, while AN-R group reported lower copper plasma concentration. There appeared to be no significant differences for zinc, vitamin B9, vitamin D, and vitamin B1 concentrations between the two types of AN patients.

The study concluded that severely malnourished AN patients tend to have numerous micronutrient deficiencies. Micronutrients status of AN patients should be monitored and they should be provided supplementation in order to prevent complications related to such deficiencies as well as to improve their nutritional status.

Source: Hanachi M, Dicembre M, Rives-Lange C, et al. Micronutrients Deficiencies in 374 Severely Malnourished Anorexia Nervosa Inpatients. Nutrients 2019;11(4):792.