Abnormalities of the respiratory function and control of ventilation in patients with anorexia nervosa.
BACKGROUND
Anorexia nervosa is a good model to study the effects of malnutrition on the respiratory system, since it excludes the consequences that some chronic diseases can have on the lung.


OBJECTIVE
The objective of this study was to assess pulmonary function and alterations in the respiratory system in patients with anorexia nervosa.


METHODS
Twenty-two women, 12 with anorexia nervosa and 10 healthy volunteers, were studied. Anthropometric data were gathered for all the participants. In every case, an arterial blood gas test and functional respiratory study, that included spirometry, plethysmography, measure of maximum muscular respiratory pressure and study of the ventilatory pattern at baseline and after hypercapnic stimulation, were performed.


RESULTS
No significant differences were found in mean age and height in both groups of patients but there was a difference in body mass index (p < 0.05). In pulmonary function tests, an increase in residual volume (RV), RV/total lung capacity (TLC) ratio and functional residual capacity and a decrease in maximum respiratory pressure were found in patients with anorexia nervosa compared to the control group (p < 0.05). Differences were also found in the ventilatory pattern, with a reduction in minute ventilation and occlusion pressure as well as a decreased response of these parameters to hypercapnic stimulation (p < 0.05) in the patients with anorexia nervosa.


CONCLUSIONS
In patients with anorexia nervosa, a significant elevation in RV, in the RV/TLC ratio and in functional residual capacity and a decrease in the maximum respiratory pressure were noted. In addition, they present an alteration in the central respiratory drive and a response of the respiratory system to hypercapnic stimulation. Although these alterations have no repercussion on the maintenance of gas exchange in baseline conditions, they may have in extreme situations.
González-Moro
J M R
JM
Department of Pneumology, Hospital General Universitario Gregorio Marañón, Madrid, Spain. jrg04m@saludalia.com
De Miguel-Díez
J
J
Paz-González
L
L
Buendía-García
M J
MJ
Santacruz-Siminiani
A
A
De Lucas-Ramos
P
P
D000328:Adult; D000856:Anorexia Nervosa / Q000503:physiopathology*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D011446:Prospective Studies; D012119:Respiration; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology; D013147:Spirometry