Meta-analysis of the clinical effectiveness and safety of initial high-calorie refeeding for the treatment of adolescent anorexia nervosa
10.3760/cma.j.cn115822-20240124-00017
- VernacularTitle:初始高热量再喂养方案治疗青少年神经性厌食症的疗效和安全性Meta分析
- Author:
Min LIU
1
;
Wan TIAN
;
Sumei WANG
;
Yan QU
;
Chun GUAN
Author Information
1. 青岛大学护理学院，青岛 266071
- Publication Type:Journal Article
- Keywords:
Adolescents;
Anorexia nervosa;
High-calorie refeeding;
Meta-analysis
- From:
Chinese Journal of Clinical Nutrition
2024;32(6):338-346
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical effectiveness and safety of a high-calorie refeeding (HCR) regimen for the treatment of adolescent anorexia nervosa.Methods:Databases including PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang Data, VIP, and SinoMed were searched for studies on the clinical effectiveness and safety of HCR regimens in children and adolescents with anorexia nervosa. Both randomized controlled trials and quasi-randomized controlled trials were screened. The search was limited to publications from the construction of the databases to October 20, 2023. Two researchers independently conducted the literature screening, data extraction and quality assessment. Meta-analysis was performed using RevMan 5.4 software.Results:A total of 8 studies involving 1 145 patients were included. Among them, 604 were in the HCR group and 541 in the low-calorie refeeding group. Meta-analysis showed that the weight gain of patients in the HCR group was higher than that in the low-calorie refeeding group, and the difference was not statistically significant ( SMD: 0.41, 95% CI: -0.03 to 0.84, P=0.06). The length of hospitalization of patients in the HCR group was shorter than that in the low-calorie refeeding group, and the difference was statistically significant ( MD: -4.96,95% CI: -8.71 to -1.20, P=0.01). The incidence of hypophosphatemia as a part of refeeding syndrome in patients in the HCR group were not statistically different compared with those in the low-calorie refeeding group ( OR: 0.95, 95% CI 0.51 to 1.75, P=0.87). Conclusions:HCR regimens are more likely to promote weight regain and shorten hospitalization without increasing the risk of developing refeeding syndrome or hypophosphatemia. This study supports the clinical effectiveness of HCR regimens for the treatment of adolescents with anorexia nervosa, with favorable safety and feasibility in clinical practice.
