Pancreatic Enzyme Elevation in Adolescents with Eating Disorders
Location
Philadelphia, PA
Start Date
9-5-2018 1:00 PM
Description
Introduction: Serum amylase has been noted to be elevated in some patients with eating disorders, particularly with purging behaviors. This is presumed to be due to salivary activation, although pancreatic lipase levels have not been included in most studies. This report aims to describe pancreatic enzyme levels in adolescents and children with eating disorders and their relationship to diagnosis, percentage median BMI (%mBMI), percentage weight loss, and purging behaviors.
Methods: Medical records of 215 patients ages 7-23 years with DSM-5 ED diagnosis who presented for inpatient treatment at CHOP from October 2012 to September 2014 were retrospectively reviewed. 157 patients had amylase and/or lipase levels measured within 48 hours of admission and these patients were included. Statistical analyses included standard descriptive testing, chi-squared tests, t-tests, and Spearman correlations.
Results: Patients averaged 15.5 years old (SD 2.6, range 7.3-23.2); 66% had anorexia nervosa, 17% atypical anorexia, 5% bulimia nervosa, 5% purging disorder, 3% avoidant-restrictive food intake disorder and 4% unspecified food and eating disorder. The mean amylase level was 70.5 (n=151, SD 27.0, range 29-190); 3% of patients presented with low amylase levels, while 12% of patients had high amylase. The mean lipase level was 110.4 (n=149, SD 96.0, range 25-1073). No patient presented with a low lipase level, while 37% of patients had high lipase. Amylase and lipase values were significantly correlated (r=0.494, p<0.01). Purgers were less likely to have high lipase levels compared with nonpurgers (23 vs 41%, p=0.047) and more likely to have high amylase levels (23 vs 9%, p=0.047). Neither pancreatic enzyme was associated with binge eating. Lower %mBMI at presentation correlated with increased lipase levels (r= - 0.162, p<0.05). Patients with high lipase levels did not have a higher mean percentage weight loss prior to admission (22 vs 18%, p=0.056).
Conclusions: Elevated amylase and lipase levels were not uncommon in this sample of adolescents with eating disorders, with one-third of patients presenting with elevated lipase. Levels did not seem to indicate clinical pancreatitis. Purgers were less likely to have high lipase levels but more likely to have high amylase levels. Higher lipase levels correlated significantly with lower %mBMI. The clinical significance of pancreatic enzyme elevations needs to be explored to identify changes in these values with refeeding.
Embargo Period
5-31-2018
Pancreatic Enzyme Elevation in Adolescents with Eating Disorders
Philadelphia, PA
Introduction: Serum amylase has been noted to be elevated in some patients with eating disorders, particularly with purging behaviors. This is presumed to be due to salivary activation, although pancreatic lipase levels have not been included in most studies. This report aims to describe pancreatic enzyme levels in adolescents and children with eating disorders and their relationship to diagnosis, percentage median BMI (%mBMI), percentage weight loss, and purging behaviors.
Methods: Medical records of 215 patients ages 7-23 years with DSM-5 ED diagnosis who presented for inpatient treatment at CHOP from October 2012 to September 2014 were retrospectively reviewed. 157 patients had amylase and/or lipase levels measured within 48 hours of admission and these patients were included. Statistical analyses included standard descriptive testing, chi-squared tests, t-tests, and Spearman correlations.
Results: Patients averaged 15.5 years old (SD 2.6, range 7.3-23.2); 66% had anorexia nervosa, 17% atypical anorexia, 5% bulimia nervosa, 5% purging disorder, 3% avoidant-restrictive food intake disorder and 4% unspecified food and eating disorder. The mean amylase level was 70.5 (n=151, SD 27.0, range 29-190); 3% of patients presented with low amylase levels, while 12% of patients had high amylase. The mean lipase level was 110.4 (n=149, SD 96.0, range 25-1073). No patient presented with a low lipase level, while 37% of patients had high lipase. Amylase and lipase values were significantly correlated (r=0.494, p<0.01). Purgers were less likely to have high lipase levels compared with nonpurgers (23 vs 41%, p=0.047) and more likely to have high amylase levels (23 vs 9%, p=0.047). Neither pancreatic enzyme was associated with binge eating. Lower %mBMI at presentation correlated with increased lipase levels (r= - 0.162, p<0.05). Patients with high lipase levels did not have a higher mean percentage weight loss prior to admission (22 vs 18%, p=0.056).
Conclusions: Elevated amylase and lipase levels were not uncommon in this sample of adolescents with eating disorders, with one-third of patients presenting with elevated lipase. Levels did not seem to indicate clinical pancreatitis. Purgers were less likely to have high lipase levels but more likely to have high amylase levels. Higher lipase levels correlated significantly with lower %mBMI. The clinical significance of pancreatic enzyme elevations needs to be explored to identify changes in these values with refeeding.