TY - JOUR
T1 - The metabolic underpinning of eating disorders
T2 - A systematic review and meta-analysis of insulin sensitivity
AU - Ilyas, Athif
AU - Hübel, Christopher
AU - Stahl, Daniel
AU - Stadler, Marietta
AU - Ismail, Khalida
AU - Breen, Gerome
AU - Treasure, Janet
AU - Kan, Carol
PY - 2018/10/28
Y1 - 2018/10/28
N2 - Background A recent study reported a positive genetic correlation between anorexia nervosa and insulin sensitivity using data from genome-wide association studies. Epidemiological studies have, on the other hand, suggested that bulimia nervosa and binge-eating disorder are associated with decreased insulin sensitivity. The aim of this study was to conduct a systematic review and meta-analysis of insulin sensitivity across the spectrum of eating disorders. Methods EMBASE, Medline, and PsycINFO were searched for all relevant studies published until January 2017, and retrieved studies were assessed for eligibility by two independent reviewers as per predefined inclusion criteria. The associations between eating disorder subtypes and insulin sensitivity were analysed separately. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size using random effects. Results Of 296 citations retrieved, 22 studies met the inclusion criteria, and 12 studies had appropriate data for meta-analysis. Using the random effects model, the pooled effect size (95% confidence interval) was 1.66 (0.79, 2.54) in people with anorexia nervosa (n = 340) and −0.57 (−0.80, −0.34) in people with bulimia nervosa (n = 120) and binge-eating disorders (n = 3241). Interpretation Anorexia nervosa is associated with increased insulin sensitivity whilst bulimia nervosa and binge-eating disorders are associated with decreased insulin sensitivity. The possible mechanism underpinning these findings needs to be determined.
AB - Background A recent study reported a positive genetic correlation between anorexia nervosa and insulin sensitivity using data from genome-wide association studies. Epidemiological studies have, on the other hand, suggested that bulimia nervosa and binge-eating disorder are associated with decreased insulin sensitivity. The aim of this study was to conduct a systematic review and meta-analysis of insulin sensitivity across the spectrum of eating disorders. Methods EMBASE, Medline, and PsycINFO were searched for all relevant studies published until January 2017, and retrieved studies were assessed for eligibility by two independent reviewers as per predefined inclusion criteria. The associations between eating disorder subtypes and insulin sensitivity were analysed separately. Individual effect sizes were standardized, and a meta-analysis was performed to calculate a pooled effect size using random effects. Results Of 296 citations retrieved, 22 studies met the inclusion criteria, and 12 studies had appropriate data for meta-analysis. Using the random effects model, the pooled effect size (95% confidence interval) was 1.66 (0.79, 2.54) in people with anorexia nervosa (n = 340) and −0.57 (−0.80, −0.34) in people with bulimia nervosa (n = 120) and binge-eating disorders (n = 3241). Interpretation Anorexia nervosa is associated with increased insulin sensitivity whilst bulimia nervosa and binge-eating disorders are associated with decreased insulin sensitivity. The possible mechanism underpinning these findings needs to be determined.
UR - http://www.scopus.com/inward/record.url?scp=85055861074&partnerID=8YFLogxK
U2 - 10.1016/j.mce.2018.10.005
DO - 10.1016/j.mce.2018.10.005
M3 - Article
SN - 0303-7207
JO - Molecular and Cellular Endocrinology
JF - Molecular and Cellular Endocrinology
ER -