Anoreksiya Nervoza ve Karaciğer Sağlığı

Sinirsel iştah kaybı anlamına gelen Anoreksiya Nervoza (AN), düşük vücut ağırlığı, devam eden besin kısıtlaması ve bozuk beden algısı ile karakterize psikiyatrik bir hastalıktır. Her yaş grubunda görülebilen AN, genellikle erken ve orta ergenlik döneminde başlamakta olup, kadınlarda erkeklere göre daha sık görülmektedir. Anoreksiya nervoza tanılı bireyler, enerji alımının kısıtlanması veya alınan enerjinin telafi edilmesi için birtakım davranışlar (kendini kusturma, laksatif-diüretik kullanma, aşırı egzersiz yapma gibi) sergilemektedir. Bunun sonucunda, vücut ağırlığı kaybıyla doğrudan ilişkili olarak tüm organları etkileyebilecek tıbbi komplikasyonlar gelişebilmektedir. Literatürde, AN’ya özgü hepatik komplikasyonların artış gösterdiği belirtilmektedir. Açlıkla uyarılan, hepatosit hasarına ve ölümüne neden olan otofajinin, AN’da karaciğer fonksiyon bozukluğuna neden olan temel mekanizma olduğu ileri sürülmektedir. Aminotransferaz düzeylerinin artması ve karaciğer hasarının ilerlemesi, ciddi bir komplikasyon olan hipoglisemiye neden olmaktadır. Anoreksiya nervoza tedavisinde, psikiyatri, beslenme ve tıbbi uzmanlardan oluşan ekiple ortak bir yaklaşım uygulanmalıdır. Tıbbi beslenme tedavisi, enerji alımını ve ağırlık kazanımını sağlayacak şekilde bireyin ihtiyaçlarına uygun olarak planlanmalıdır. Ayrıca, davranış değişikliği ve düzenli yeme alışkanlığı kazandırmak için bireye beslenme eğitimi verilmesi faydalı olmaktadır. Yapılan çalışmalar, AN tanılı bireylerde karaciğer fonksiyon bozuklukları ve hepatik komplikasyonlarla ilişkili tıbbi durumların iyileştirilebilmesinde tıbbi beslenme tedavisinin etkili olduğunu göstermektedir. Bu derlemede, AN’da yaygın olarak görülen hepatik komplikasyonlar ve tıbbi beslenme tedavisinin karaciğer fonksiyon bozukluğu üzerine etkileri incelenmiştir.

Anahtar Kelimeler:

Anoreksiya Nervoza, Aminotransferazlar, Tıbbi Beslenme Tedavisi

Anorexia Nervosa and Liver Health

Anorexia Nervosa (AN) is, which means loss of nervous appetite, a psychiatric disorder characterized by low body weight, continuous food restriction, and impaired body perception. AN, which can be seen in all age groups, usually begins in early and middle adolescence and is more common in women than men. Individual with anorexia nervosa exhibit certain behaviors (such as self-vomiting, laxative-diuretic use, excessive exercise) to limit energy intake or compensate for the energy received. As a result, medical complications may develop which may affect all organs directly related to body weight loss. In the literature, it is indicated that an increase of AN-specific hepatic complications. It has been suggested that autophagy, which is induced by causes hepatocyte damage and death, is the main mechanism leading to liver dysfunction in AN. Increased aminotransferase levels and progression of liver damage cause hypoglycemia, a serious complication. In the treatment of anorexia nervosa, a joint approach with a team of psychiatry, nutrition, and medical experts should be applied. Medical nutritional therapy should be planned in accordance with the needs of the individuals to ensure to achieve energy intake and weight gain. Besides, it is beneficial to give additional nutritional education to the individuals for improving regular eating habits and behavioral change. Studies have shown that medical nutritional therapy is effective in improving liver function disorders and medical conditions associated with hepatic complications in individuals with AN. In this review, common hepatic complications and the effects of medical nutritional therapy on liver dysfunction have been investigated.

Keywords:

Anorexia nervosa, Aminotransferases, Medical nutritional therapy,

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