ABSTRACT
Blood biochemistry, body composition, and resting energy expenditure were studied in 25 patients with anorexia nervosa admitted to hospital during a period of 18 months. The patients' ages ranged from 12.9 to 17.2 years, and the abnormal feeding history from 3 to 12 months. Blood chemistry values were in the normal range, but fat body mass and lean body mass were reduced and extracellular water volume was expanded beyond normal values. Resting energy expenditure was reduced to 49% to 91% of values predicted by the Harris-Benedict equations. Substrate use after overnight fast indicated an abnormally high use of carbohydrates. Significant correlations were found between extracellular water volume and triceps skin-fold thickness, mid-arm muscle circumference and lean body mass, and substrate use and weight loss as a percentage of initial weight. We suggest that these simple anthropometric measurements can be used to assess and monitor the refeeding of patients with anorexia nervosa.
Subject(s)
Anorexia Nervosa/physiopathology , Body Composition , Energy Metabolism , Adolescent , Anorexia Nervosa/pathology , Anthropometry , Body Water , Child , Female , Humans , Male , Skinfold ThicknessABSTRACT
Changes in body composition were studied in 13 girls with anorexia nervosa before and during 2 months of refeeding. Fat body mass and fat-free body mass were derived from skin-fold measurements. Total body potassium was measured by whole body counter, and intracellular water was calculated from it. Extracellular water was measured as the bromide space after oral bromide administration. A gradual increase was noted in weight, fat body mass, fat-free body mass, and total body potassium during refeeding. Extracellular water was expanded on admission and increased in all patients in the first weeks of treatment; later it fell to normal. Most of the changes in fat-free body mass over the first weeks of refeeding could be accounted for by an expansion in extracellular water. Particular care must therefore be taken with fluid balance during the first few weeks of refeeding.
Subject(s)
Anorexia Nervosa/diet therapy , Body Composition , Adipose Tissue , Adolescent , Body Water , Child , Extracellular Space , Female , Humans , Intracellular Fluid , Potassium/analysisABSTRACT
We studied the disposition of inhaled salbutamol in adolescents with cystic fibrosis (CF) and compared it with the pharmacokinetics of the drug given by the intravenous and inhaled routes in healthy adults. After inhalation of salbutamol, CF patients had a significantly larger area under the concentration-time curve derived from amounts of drug in the systemic circulation. The differences in serum concentration of salbutamol were not reflected in differences in change of heart rate. We conclude that the rate and extent of pulmonary absorption of inhaled salbutamol in patients with CF differ from those in healthy adults.
Subject(s)
Albuterol/pharmacokinetics , Cystic Fibrosis/metabolism , Administration, Inhalation , Adolescent , Adult , Albuterol/administration & dosage , Albuterol/blood , Biological Availability , Cystic Fibrosis/drug therapy , Humans , Reference ValuesABSTRACT
Resting energy expenditure was measured by open-circuit indirect calorimetry in 71 patients, aged 8.9 to 35.5 years, with cystic fibrosis who had no recent history of acute lung infection. Pulmonary function and nutritional status were studied simultaneously. In most patients, resting energy expenditure was above normal (range 95% to 153% of predicted values for age, sex, and weight as derived from the Harris Benedict equations), and was negatively correlated with pulmonary function (P less than 0.01) and nutritional status (P less than 0.01) when expressed as a percentage of body fat. Pulmonary status was positively correlated with nutritional status (P less than 0.01). We conclude that resting energy expenditure in patients with cystic fibrosis exceeds normal values and that the increase correlates with a deterioration in lung function and nutritional status.