title: The longitudinal BMI pattern and body composition of patients with anorexia nervosa who require urgent hospitalization: A case control study.
abstract: BACKGROUND
  The prevention of serious physical complications in anorexia nervosa (AN) patients is important. The purpose of this study is to clarify which physical and social factors are related to the necessity for urgent hospitalization of anorexia nervosa (AN) patients in a long-term starvation state. We hypothesized that the change of longitudinal BMI, body composition and social background would be useful as an index of the necessity for urgent hospitalization.
  
  
  METHODS
  AN patients were classified into; urgent hospitalization, due to disturbance of consciousness or difficulty walking(n = 17); planned admission (n = 96); and outpatient treatment only groups (n = 136). The longitudinal BMI pattern and the clinical features of these groups were examined. In the hospitalization groups, comparison was done of body composition variation and the social background, including the educational level and advice from family members.
  
  
  RESULTS
  After adjusting for age and duration of illness, the BMI of the urgent hospitalization group was lower than that of the other groups at one year before hospitalization (P < 0.01) and decreased more rapidly (P < 0.01). Urgent hospitalization was associated with the fat free mass (FFM) (P < 0.01). Between the groups, no considerable difference in social factors was found.
  
  
  CONCLUSIONS
  The longitudinal pattern of BMI and FFM may be useful for understanding the severity in AN from the viewpoint of failure of the homeostasis system.
authors.affiliation: Department of Psychosomatic Medicine, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan, 3-1-1 Higashi-ku, Fukuoka, Japan 812-8582. kawai@cephal.med.kyushu-u.ac.jp.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kawai
authors.forename: Sakino
authors.initials: S
authors.lastname: Yamashita
authors.forename: Takeharu
authors.initials: T
authors.lastname: Yamanaka
authors.forename: Motoharu
authors.initials: M
authors.lastname: Gondo
authors.forename: Chihiro
authors.initials: C
authors.lastname: Morita
authors.forename: Takehiro
authors.initials: T
authors.lastname: Nozaki
authors.forename: Shu
authors.initials: S
authors.lastname: Takakura
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Hata
authors.forename: Yu
authors.initials: Y
authors.lastname: Yamada
authors.forename: Sunao
authors.initials: S
authors.lastname: Matsubayashi
authors.forename: Masato
authors.initials: M
authors.lastname: Takii
authors.forename: Chiharu
authors.initials: C
authors.lastname: Kubo
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Sudo