Adverse Effects of Refeeding on the Plasma Lipidome in Young Individuals With Anorexia Nervosa? - 18/11/21
Abstract |
Objective |
Refeeding is the cornerstone of anorexia nervosa (AN) treatment, but little is known regarding the optimal pace and dietary composition or possible adverse effects of current clinical practices. Plasma lipids may be a moderating factor underlying unfavorable refeeding effects in AN, such as an abnormal central body fat distribution. The objective of this study was to analyze the plasma lipidome in the acutely underweight state of AN before and after refeeding.
Method |
Using high-throughput quantitative mass spectrometry−based shotgun lipidomics, we measured 13 lipid classes and 204 lipid species or subspecies in the plasma of young female patients with acute AN, before (n = 39) and after (n = 23) short-term weight restoration during an intensive inpatient refeeding program (median body mass index [BMI] increase = 26.4%), in comparison to those in healthy control participants (n = 37).
Results |
Before inpatient treatment, patients with AN exhibited increased concentrations of cholesterol and several other lipid classes. After refeeding, multiple lipid classes including cholesterol and ceramides, as well as certain ceramide species previously associated with obesity or overfeeding, showed increased concentrations, and a pattern of shorter and more saturated triacylgycerides emerged. A machine learning model trained to predict BMI based on the lipidomic profiles revealed a sizable overprediction in patients with AN after weight restoration.
Conclusion |
The results point toward a profound lipid dysregulation with similarities to obesity and other features of the metabolic syndrome after short-term weight restoration. Thus, this study provides evidence for possible short-term adverse effects of current refeeding practices on the metabolic state and should inspire more research on nutritional interventions in AN.
Le texte complet de cet article est disponible en PDF.Key words : anorexia nervosa, inpatient treatment, lipidomics, ceramides, refeeding
Plan
| This work was supported by the Deutsche Forschungsgemeinschaft (German Research Foundation, SFB 940/2, EH 367/5-1, EH 367/7-1), the Swiss Anorexia Nervosa Foundation, and the B. Braun Foundation. The funding sources had no involvement in the study design, the collection, analysis, and interpretation of data, the writing of the report, or the decision to submit the article for publication. |
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| The research was performed with permission from the Ethics committee of the Technische Universität Dresden. |
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| Dr. Gerl served as the statistical expert for this research. |
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| Author Contributions |
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| Conceptualization: Tam, Gerl, King, Seidel, Roessner, Simons, Ehrlich |
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| Data curation: Tam, King, Seidel, Ehrlich |
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| Formal analysis: Tam, Gerl |
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| Funding acquisition: Tam, Ehrlich |
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| Investigation: Tam, Gerl, Klose, Surma, King, Seidel, Weidner, Ehrlich |
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| Methodology: Gerl, Klose, Surma, Simons |
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| Project administration: Tam, King, Seidel, Ehrlich |
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| Resources: Gerl, Klose, Surma, Weidner, Roessner, Simons, Ehrlich |
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| Software: Gerl, Klose, Surma, Simons |
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| Supervision: Simons, Ehrlich |
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| Validation: Simons, Ehrlich |
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| Visualization: Gerl |
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| Writing – original draft: Tam, Ehrlich |
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| Writing – review and editing: Gerl, Klose, Surma, King, Seidel, Weidner, Roessner, Simons, Ehrlich |
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| Disclosure: Dr. Tam has received a research grant from the “Marga und Walter Boll-Stiftung.” Dr. Gerl has reported being an employee of Lipotype GmbH. Drs. Klose and Surma have reported being shareholders of Lipotype GmbH. Prof. Dr. Roessner has received payment for consulting and writing activities from Eli Lilly and Co., Novartis, and Shire Pharmaceuticals/Takeda, lecture honoraria from Eli Lilly and Co., Novartis, Shire Pharmaceuticals/Takeda, and Medice Pharma, and support for research from Shire Pharmaceuticals/Takeda and Novartis. He has carried out (and is currently carrying out) clinical trials in cooperation with Novartis, Shire Pharmaceuticals/Takeda, Servier, and Otsuka. He has reported no financial relationship with the organizations that sponsored the research. Prof. Dr. Simons has reported being CEO of Lipotype GmbH. Prof. Dr. Ehrlich has received a research grant from the “Marga und Walter Boll-Stiftung.” Drs. King and Seidel and Prof. Dr. Weidner have reported no biomedical financial interests or potential conflicts of interest. |
Vol 60 - N° 12
P. 1479-1490 - décembre 2021 Retour au numéro
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