Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Cardiac Complications Associated with Eating Disorders in Children: A Multicenter Retrospective Study

  • Choi, So Yoon (Department of Pediatrics, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Lee, Kyung Jae (Department of Pediatrics, College of Medicine, Hallym University) ;
  • Kim, Soon Chul (Department of Pediatrics, Jeonbuk National University Medical School and Hospital) ;
  • Lee, Eun Hye (Department of Pediatrics, Nowon Eulji Medical Center, Eulji University) ;
  • Lee, Yoo Min (Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Yu-Bin (Department of Pediatrics, Ajou University School of Medicine) ;
  • Yi, Dae Yong (Department of Pediatrics, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Kim, Ju Young (Department of Pediatrics, Daejeon Eulji Medical Center, Eulji University) ;
  • Kang, Ben (Department of Pediatrics, School of Medicine, Kyungpook National University) ;
  • Jang, Hyo-Jeong (Department of Pediatrics, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Hong, Suk Jin (Department of Pediatrics, Daegu Catholic University School of Medicine) ;
  • Choi, You Jin (Department of Pediatrics, Inje University Ilsan Paik Hospital) ;
  • Kim, Hyun Jin (Department of Pediatrics, Chungnam National University Hospital, Chungnam National University College of Medicine)
  • Received : 2022.02.21
  • Accepted : 2022.07.20
  • Published : 2022.09.15
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Abstract

Purpose: Eating disorders often result in somatic complications, including cardiac abnormalities. Cardiac abnormalities may involve any part of the heart, including the cardiac conduction system, and can lead to sudden cardiac death. The current study aimed to evaluate the incidence of cardiac complications in pediatric patients with eating disorders and their associated factors. Methods: We retrospectively analyzed patients aged 10-18 years who were diagnosed with DSM-V (Diagnostic and Statistical Manual of Mental Disorder-V) eating disorders and underwent electrocardiography (ECG) and/or echocardiography between January 2015 and May 2020. Results: In total, 127 patients were included, of whom 113 (89.0%) were female. The median body mass index (BMI) was 15.05±3.69 kg/m2. Overall, 74 patients (58.3%) had ECG abnormalities, with sinus bradycardia being the most common abnormality (91.9%). Patients with ECG abnormalities had significantly lower BMI (14.35±2.78 kg/m2 vs. 16.06± 4.55 kg/m2, p<0.001) than patients without ECG abnormalities, as well as lower phosphorus and higher cholesterol levels. Among the 46 patients who underwent echocardiographic evaluation, 23 (50.0%) had echocardiographic abnormalities, with pericardial effusion being the most common (60.9%). The median left ventricular mass (LVM) and ejection fraction were 67.97±21.25 g and 66.91±28.76%, respectively. LVM and BMI showed a positive correlation (r=0.604, p<0.001). After weight gain, the amount of pericardial effusion was reduced in 3 patients, and 30 patients presented with normal ECG findings. Conclusion: Cardiac abnormalities are relatively frequent in patients with eating disorders. Physicians should focus on this somatic complication and careful monitoring is required.

Keywords

Acknowledgement

This work was supported by a grant from the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition, and a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (No.2021M3E5D1A02015263).

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