{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:10:01Z","timestamp":1784031001883,"version":"3.55.0"},"reference-count":80,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Experimental Physiology"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    In anorexia nervosa (AN), prolonged metabolic adaptation to severe energy deficiency can impair treatment efficacy. Similarly, low energy availability poses a recognized risk to athletes, potentially compromising health and performance. This cross\u2010sectional study aimed to characterize the plasma metabolic pattern of females with varying physical conditions, including AN patients, athletes, and normal weight, overweight and obese females. Non\u2010targeted metabolomics was applied to plasma samples from 107 females aged 18\u201340\u00a0years. Body fat was assessed via ultrasound and bioimpedance analysis. Nutritional intake, physical activity and clinical parameters were evaluated through standardized assessments. Sixty metabolites related to lipid, phospholipid and amino acid metabolism differed significantly between groups (ANOVA, false discovery rate\n                    <jats:italic>q<\/jats:italic>\n                    \u00a0&lt;\u00a00.05). AN patients showed reduced long\u2010chain free fatty acids, medium\u2010chain acylcarnitines, etherphospholipids and branched\u2010chain amino acids (BCAAs) (Cohen's\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0&lt;\u00a0\u22120.5), alongside increased lysophospholipids and glycerophosphocholine (\n                    <jats:italic>d<\/jats:italic>\n                    \u00a0&gt;\u00a00.6). Athletes exhibited a similar though less pronounced pattern, with preserved BCAA levels, while overweight and obese individuals displayed opposing patterns. Metabolites including fatty acids, acylcarnitines, BCAAs and phospholipids positively correlated with body fat (\n                    <jats:italic>r<\/jats:italic>\n                    <jats:sub>s<\/jats:sub>\n                    \u00a0&gt;\u00a00.25,\n                    <jats:italic>q<\/jats:italic>\n                    \u00a0&lt;\u00a00.05), whereas lysophospholipids and glycerophosphocholine correlated negatively (\n                    <jats:italic>r<\/jats:italic>\n                    <jats:sub>s<\/jats:sub>\n                    \u00a0&lt;\u00a0\u22120.25,\n                    <jats:italic>q<\/jats:italic>\n                    \u00a0&lt;\u00a00.05). The metabolic pattern in AN may be consistent with metabolism alterations in energy\u2010deficiency states, which may be associated with structural tissue loss. Athletes demonstrated similar shifts that may reflect adaptive responses to potential low energy availability, while overweight and obese profiles were consistent with energy surplus. These findings emphasize associations of systemic metabolism adaptations in energy\u2010imbalance states and highlight the importance of adequate energy intake in vulnerable groups to maintain metabolic and structural integrity and prevent adverse health consequences.\n                  <\/jats:p>","DOI":"10.1113\/ep092957","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T12:01:11Z","timestamp":1784030471000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic pattern across energy imbalance: An exploratory metabolomics study of female body weight extremes including anorexia nervosa and athletes"],"prefix":"10.1113","author":[{"given":"Sonja","family":"Lackner","sequence":"first","affiliation":[{"name":"Division of Pathophysiology and Immunology, Otto Loewi Research Center Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olli","family":"K\u00e4rkk\u00e4inen","sequence":"additional","affiliation":[{"name":"Afekta Technologies Ltd  Kuopio Finland"},{"name":"School of Pharmacy University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"M\u00f6rkl","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Psychotherapeutic Medicine Medical University of Graz  Graz Austria"},{"name":"Department of Medical Psychology, Psychosomatics and Psychotherapy Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfram","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Division of Biophysics, Gottfried Schatz Research Center Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"F\u00fcrhapter\u2010Rieger","sequence":"additional","affiliation":[{"name":"Division of Physiology, Otto Loewi Research Center Medical University of Graz  Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kati","family":"Hanhineva","sequence":"additional","affiliation":[{"name":"Afekta Technologies Ltd  Kuopio Finland"},{"name":"Food Sciences Unit, Department of Life Technologies University of Turku  Turku Finland"},{"name":"Institute of Public Health and Clinical Nutrition School of Medicine University of Eastern Finland  Kuopio Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2958-3516","authenticated-orcid":false,"given":"Sandra Johanna","family":"Holasek","sequence":"additional","affiliation":[{"name":"Division of Pathophysiology and Immunology, Otto Loewi Research Center Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"issue":"5","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1093\/nutrit\/nuw001","article-title":"Physical activity in patients with anorexia nervosa","volume":"74","author":"Achamrah N.","year":"2016","journal-title":"Nutrition Reviews"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425787","volume-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2022"},{"issue":"1","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00421-020-04516-0","article-title":"Low energy availability: History, definition and evidence of its endocrine, metabolic and physiological effects in prospective studies in females and males","volume":"121","author":"Areta J. 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