593 - Liver function tests, lipase levels, and complete blood counts among adolescents with restrictive eating disorders: what are the differences?

Publication Number: 593.5688

Hanna Suh, Case Western Reserve University School of Medicine, Cleveland, OH, United States; Lise DeShea, University of Oklahoma College of Medicine, Oklahoma City, OK, United States; Stephanie Ferrin, Oklahoma Childrens Hospital at OU Health, Oklahoma City, OK, United States; Briana Griffin, University of Oklahoma College of Medicine, Yukon, OK, United States; Amy B. Middleman, UH Rainbow Babies & Children's Hospital, Cleveland, OH, United States

Background: Anorexia nervosa (AN) has been associated with abnormal liver function tests (LFTs) and hematologic tests; less is known about these complications for those with avoidant restrictive food intake disorder (ARFID).

Objective: To explore possible associations between eating disorder diagnosis and serologic test results for alanine transaminase (ALT), aspartate aminotransferase (AST), lipase, white blood cell count (WBC), hemoglobin (hgb), and platelets (plt).

Design/Methods: Data were collected from adolescent patients in a disordered eating program in a southwestern state between 2013 and 2023; the Institutional Review Board approved database development/analysis. This analysis examined associations between ALT, AST, lipase, hgb, plt, and WBC and the diagnosis of AN versus ARFID, body mass index (BMI), age of diagnosis, duration of illness, and calorie-dense food intake. Wilcoxon’s rank-sum test, Welch’s t test, chi square test, and generalized linear models were conducted. Log transformations were used to ensure skewness did not influence inferential findings. Analyses were performed using R.

Results: Table 1 shows results for 123 patients with AN and 100 patients with ARFID. A significantly higher percentage of patients of female natal sex was observed in the AN group (89%) compared to the ARFID group (61%). The AN cohort was significantly older than the ARFID group (means 15.7 versus 14.6 years), although the medians were equal and clinical significance is unlikely. The AN group (median 16.6 kg/m^2) had higher BMI than the ARFID group (median 15.6 kg/m^2); the groups did not differ statistically on percentage of median BMI for age (%mBMI; medians 83.0 vs. 83.1, respectively). Patients with AN had significantly higher ALT levels than those with ARFID (medians 20.0 vs 15.0 U/L). Figure 1 displays LFT and CBC results by group. WBC and plt were higher in patients with ARFID (medians: WBC, 7.1 cells/mL; plt, 264.0 mcL) vs. patients with AN (medians: WBC, 5.5 cells/mL; plt, 231.0 mcL). In two-predictor models also containing diagnosis, reported calorie-dense food consumption predicted higher WBC and plt levels, with the ARFID group having higher levels on both tests, compared to AN. Separate models assessing duration of illness, age, and %mBMI did not add significantly to diagnosis as a predictor of LFTs.

Conclusion(s): These findings indicate differences in ALT, WBC, and plt for adolescent patients presenting with AN versus ARFID, most likely based on the specific characteristics of each disorder. Further study is warranted to explore multivariable models containing other covariates.

Figure 1
Liver function test and complete blood count results based on AN or ARFID group

Table 1
Sample Demographics and Lab Results