Evaluation of muscle-skeletal strength and peak expiratory flow in severely malnourished inpatients with anorexia nervosa: A pilot study.
Nutrition. 2021-05-01; 85: 111133
DOI: 10.1016/j.nut.2020.111133
Lire sur PubMed
Minano Garrido E(1), Di Lodovico L(2), Dicembre M(1), Duquesnoy M(3), Ohanyan H(4), Melchior JC(5), Hanachi M(6).
Author information:
(1)Clinical Nutrition Unit, Paul Brousse University Hospital, Villejuif, France;
University of Versailles, St Quentin-en-Yvelines, Montigny-le-Bretonneux,
France.
(2)Clinical Nutrition Unit, Paul Brousse University Hospital, Villejuif, France;
Clinique des Maladies Mentales et de l’Encéphale, GHU Paris Psychiatrie, Paris,
France. Electronic address: .
(3)Clinical Nutrition Unit, Paul Brousse University Hospital, Villejuif, France;
Paris-Saclay University, Paris, France.
(4)Clinical Nutrition Unit, Paul Brousse University Hospital, Villejuif, France.
(5)Clinical Nutrition Unit, Paul Brousse University Hospital, Villejuif, France;
University of Versailles, St Quentin-en-Yvelines, Montigny-le-Bretonneux,
France; Paris-Saclay University, Paris, France.
(6)Clinical Nutrition Unit, Paul Brousse University Hospital, Villejuif, France;
Paris-Saclay University, Paris, France; MICALIS Institute, INRAE, Jouy-en-Josas,
France.
OBJECTIVES: Anorexia nervosa is a complex psychiatric disorder that can lead to
specific somatic complications. Malnutrition is frequent and can involve a
decrease of mobility, up to functional impotence, in individuals with extremely
severe cases. The aim of this pilot study was to examine muscle strength and
peak expiratory flow (PEF) in severely undernourished patients with anorexia
nervosa at admission and after 5 wk of renutrition by tube feeding, and to find
the clinical and biological correlates of muscle-strength impairment.
METHODS: A prospective observational study was conducted over 6 mo. Manual
muscle testing, measures of PEF, and clinical and biologic assessments were
performed at baseline and after 5 wk of renutrition.
RESULTS: Twenty-three extremely malnourished female participants (mean body mass
index: 11.4 ± 1.3 kg/m2) were included. All participants had global impairment
in muscle strength (manual muscle testing: 37.7 ± 7.7) and PEF (253.3 ± 60
mL/min) at admission. Muscle weakness was higher in axial than peripheral muscle
groups (P < 0.01), with no significant difference between proximal and distal muscles (P > 0.05). Muscle strength at admission was significantly associated
with severity of undernourishment (body mass index and albumin) and
transaminitis (P < 0.05). At follow-up, musculoskeletal strength and PEF were
significantly improved after partial weight recovery (P < 0.01).
CONCLUSIONS: Extremely undernourished people with anorexia nervosa present a
decrease of PEF and musculoskeletal strength predominant on axial muscles. Both
are associated with severity of malnutrition and liver damage. Partial recovery
was observed after 5 wk of enteral nutrition.
Copyright © 2021 Elsevier Inc. All rights reserved.
DOI: 10.1016/j.nut.2020.111133
PMID: 33549945 [Indexed for MEDLINE]
Conflict of interest statement: Declaration of interests The authors declare
that they have no known competing financial interests or personal relationships
that could have appeared to influence the work reported in this paper.