Differences in serum zinc levels in acutely ill and remitted adolescents and young adults with bulimia nervosa in comparison with healthy controls – a cross-sectional pilot study
Received 20 March 2017
Accepted for publication 22 June 2017
Published 17 October 2017 Volume 2017:13 Pages 2621—2630
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Wai Kwong Tang
Florian D Zepf,1,2 Pradeep Rao,1,3 Kevin Runions,3,4 Richard M Stewart,1 Julia K Moore,1,5 Janice WY Wong,1,4 Maike Linden,1,2,6 Idil Sungurtekin,7 Franziska Glass,8 Linda Gut,8 Dirk Peetz,9,10 Gudrun Hintereder,11 Michael Schaab,12 Fritz Poustka,8 Lars Wöckel8,13
1Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Western Australia, 2Specialised Child and Adolescent Mental Health Services (CAMHS), Department of Health in Western Australia, 3Community Child and Adolescent Mental Health Services, Department of Health in Western Australia, 4Telethon Kids Institute, University of Western Australia, 5Paediatric Consultation-Liaison Program, Child and Adolescent Mental Health Services, Department of Health in Western Australia, Perth, WA, Australia; 6Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, 7Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannheim, 8Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Goethe University, Frankfurt am Main, 9Institute of Laboratory Medicine, HELIOS Klinikum Berlin-Buch, Berlin, 10Department of Clinical Chemistry and Laboratory Medicine, University Center of the Johannes Gutenberg University Mainz, Mainz, 11Department of Laboratory Medicine, Goethe University, Frankfurt am Main, 12Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany; 13Center of Child and Adolescent Psychiatry and Psychotherapy, Clienia Littenheid AG, Littenheid, Switzerland
Background: Research has implicated that changes in zinc (Zn) metabolism may be associated with the biological underpinnings of eating disorders, in particular anorexia nervosa. However, to date research on the role of Zn in patients with bulimia nervosa (BN) is scarce.
Objective: We aimed to explore serum Zn concentrations in young patients with BN, with a focus on the stage of the disorder, comparing acutely ill and recovered patients with BN with healthy controls.
Methods: Serum Zn concentrations were obtained from healthy controls and from acutely ill and remitted young patients with BN. Mean duration of remission was 4.0±3.5 years.
Results: Remitted patients showed elevated serum Zn concentrations when compared to controls (Cohen’s d=2.022), but concentrations were still in the normal range. Acutely ill patients also had higher serum Zn levels when compared to controls (all values still being within the reference range, Cohen’s d=0.882). There was no difference between acutely ill and remitted patients with BN in serum Zn concentrations. Of note, remitted patients had a significantly higher body weight when compared to the other two groups. Overall, there were no significant differences in dietary preferences with regard to Zn containing foods between the groups.
Conclusion: The present study provides preliminary evidence that the underlying factors for changes in Zn serum concentrations in young patients with BN do not vary with regard to the stage of illness (acute versus remitted BN). Further prospective research is needed in order to disentangle the possible interplay between serum Zn status and bulimic eating behaviors.
Keywords: bulimia nervosa, zinc, serum concentrations, remission, eating disorders
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