{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T23:58:53Z","timestamp":1773878333719,"version":"3.50.1"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"JSPS KAKENHI","award":["19K17087"],"award-info":[{"award-number":["19K17087"]}]},{"name":"JSPS KAKENHI","award":["20K07942"],"award-info":[{"award-number":["20K07942"]}]},{"name":"JSPS KAKENHI","award":["17K00851"],"award-info":[{"award-number":["17K00851"]}]},{"DOI":"10.13039\/100009619","name":"AMED","doi-asserted-by":"crossref","award":["JP21dk0307103"],"award-info":[{"award-number":["JP21dk0307103"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Eat Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secondary carnitine deficiency in patients with anorexia nervosa has been rarely reported. This study aimed to investigate the occurrence of carnitine deficiency in severely malnourished patients with eating disorders during refeeding and assess its potential adverse effects on treatment outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      In a cohort study of 56 female inpatients with eating disorders at a single hospital from March 2010 to December 2020, we measured plasma free carnitine (FC) levels and compared to those of a healthy control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935). The patients were categorized into three groups based on FC levels: FC deficiency (FC&lt; 20 \u00b5mol\/L), FC pre-deficiency (20 \u00b5mol\/L\u2009\u2264\u2009FC&lt; 36 \u00b5mol\/L), and FC normal (36 \u00b5mol\/L\u2009\u2264\u2009FC).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Upon admission, the patients had a median age of 26 years (interquartile range [IQR]: 21\u201335) and a median body mass index (BMI) of 13.8\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (IQR: 12.8\u201314.8). Carnitine deficiency or pre-deficiency was identified in 57% of the patients. Hypocarnitinemia was associated with a decline in hemoglobin levels during refeeding (odds ratio [OR]: 0.445; 95% confidence interval [CI]: 0.214\u20130.926,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), BMI at admission (OR: 0.478; 95% CI: 0.217\u20130.874,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014), and moderate or greater hepatic impairment at admission (OR: 6.385; 95% CI: 1.170\u201340.833,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.032).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Hypocarnitinemia, particularly in cases of severe undernutrition (BMI&lt; 13\u00a0kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      at admission) was observed in severely malnourished patients with eating disorders during refeeding, a critical metabolic transition phase. Moderate or severe hepatic impairment at admission was considered a potential indicator of hypocarnitinemia. Although hypocarnitinemia was not associated with any apparent adverse events other than anemia during refeeding, the possibility that carnitine deficiency may be a risk factor for more serious complications during sudden increases in energy requirements associated with changes in physical status cannot be denied. Further research on the clinical significance of hypocarnitinemia in severely malnourished patients with eating disorders is warranted.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40337-024-01054-4","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T07:11:59Z","timestamp":1720509119000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Secondary carnitine deficiency during refeeding in severely malnourished patients with eating disorders: a retrospective cohort study"],"prefix":"10.1186","volume":"12","author":[{"given":"Miho","family":"Imaeda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoko","family":"Oya-Ito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariko","family":"Uematsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetsugu","family":"Fujigaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuniaki","family":"Saito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Ando","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norio","family":"Ozaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"issue":"10227","key":"1054_CR1","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1016\/S0140-6736(20)30059-3","volume":"395","author":"J Treasure","year":"2020","unstructured":"Treasure J, Duarte TA, Schmidt U. Eating disorders. Lancet. 2020;395(10227):899\u2013911.","journal-title":"Lancet"},{"issue":"14","key":"1054_CR2","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1056\/NEJMcp1803175","volume":"382","author":"JE Mitchell","year":"2020","unstructured":"Mitchell JE, Peterson CB. Anorexia nervosa. N Engl J Med. 2020;382(14):1343\u201351.","journal-title":"N Engl J Med"},{"issue":"3\u20134","key":"1054_CR3","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/S0022-3999(97)00267-5","volume":"44","author":"S Nielsen","year":"1998","unstructured":"Nielsen S, Moller-Madsen S, Isager T, Jorgensen J, Pagsberg K, Theander S. Standardized mortality in eating disorders\u2013a quantitative summary of previously published and new evidence. J Psychosom Res. 1998;44(3\u20134):413\u201334.","journal-title":"J Psychosom Res"},{"key":"1054_CR4","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s40337-015-0040-8","volume":"3","author":"PS Mehler","year":"2015","unstructured":"Mehler PS, Brown C. Anorexia nervosa - medical complications. J Eat Disord. 2015;3:11.","journal-title":"J Eat Disord"},{"key":"1054_CR5","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1196\/annals.1320.003","volume":"1033","author":"CJ Rebouche","year":"2004","unstructured":"Rebouche CJ. Kinetics, pharmacokinetics, and regulation of L-carnitine and acetyl-L-carnitine metabolism. Ann N Y Acad Sci. 2004;1033:30\u201341.","journal-title":"Ann N Y Acad Sci"},{"issue":"2","key":"1054_CR6","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/0887-8994(90)90037-2","volume":"6","author":"GN Breningstall","year":"1990","unstructured":"Breningstall GN. Carnitine deficiency syndromes. Pediatr Neurol. 1990;6(2):75\u201381.","journal-title":"Pediatr Neurol"},{"issue":"10","key":"1054_CR7","doi-asserted-by":"publisher","first-page":"2422","DOI":"10.1016\/j.bbamcr.2016.01.023","volume":"1863","author":"N Longo","year":"2016","unstructured":"Longo N, Frigeni M, Pasquali M. Carnitine transport and fatty acid oxidation. Biochim Biophys Acta. 2016;1863(10):2422\u201335.","journal-title":"Biochim Biophys Acta"},{"issue":"4 Suppl 4","key":"1054_CR8","doi-asserted-by":"publisher","first-page":"S4","DOI":"10.1016\/S0272-6386(03)00112-4","volume":"41","author":"C Hoppel","year":"2003","unstructured":"Hoppel C. The role of carnitine in normal and altered fatty acid metabolism. Am J Kidney Dis. 2003;41(4 Suppl 4):S4\u201312.","journal-title":"Am J Kidney Dis"},{"key":"1054_CR9","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1186\/1743-7075-7-30","volume":"7","author":"JL Flanagan","year":"2010","unstructured":"Flanagan JL, Simmons PA, Vehige J, Willcox MD, Garrett Q. Role of carnitine in disease. Nutr Metab (Lond). 2010;7:30.","journal-title":"Nutr Metab (Lond)"},{"issue":"Suppl 2","key":"1054_CR10","first-page":"S8","volume":"10","author":"R Pons","year":"1995","unstructured":"Pons R, De Vivo DC. Primary and secondary carnitine deficiency syndromes. J Child Neurol. 1995;10(Suppl 2):S8\u201324.","journal-title":"J Child Neurol"},{"issue":"2\u20133","key":"1054_CR11","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1023\/A:1024433100257","volume":"26","author":"SC Winter","year":"2003","unstructured":"Winter SC. Treatment of carnitine deficiency. J Inherit Metab Dis. 2003;26(2\u20133):171\u201380.","journal-title":"J Inherit Metab Dis"},{"key":"1054_CR12","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1186\/s40337-016-0127-x","volume":"4","author":"M Imaeda","year":"2016","unstructured":"Imaeda M, Tanaka S, Fujishiro H, Kato S, Ishigami M, Kawano N, et al. Risk factors for elevated liver enzymes during refeeding of severely malnourished patients with eating disorders: a retrospective cohort study. J Eat Disord. 2016;4:37.","journal-title":"J Eat Disord"},{"issue":"1","key":"1054_CR13","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1016\/0016-5085(93)90864-9","volume":"104","author":"EM Quigley","year":"1993","unstructured":"Quigley EM, Marsh MN, Shaffer JL, Markin RS. Hepatobiliary complications of total parenteral nutrition. Gastroenterology. 1993;104(1):286\u2013301.","journal-title":"Gastroenterology"},{"issue":"1","key":"1054_CR14","first-page":"34","volume":"35","author":"T Fukusako","year":"1995","unstructured":"Fukusako T, Negoro K, Tsuda N, Kato M, Morimatsu M. [A case of secondary carnitine deficiency due to anorexia nervosa and severe liver damage]. Rinsho Shinkeigaku. 1995;35(1):34\u20137.","journal-title":"Rinsho Shinkeigaku"},{"key":"1054_CR15","first-page":"369","volume":"41","author":"K Okamoto","year":"2001","unstructured":"Okamoto K, NT, Komaki G, Takii M, Kawai K, Matsumoto Y, Murakami S, Kubo C. A case of Anorexia Nervoxa with serum Carnitine Deficiency and High Creatine Phosphokinase Concentration during Nutritional Rehabilitation. JPM J Psychosom Med. 2001;41:369\u201375.","journal-title":"Jpm J Psychosom Med"},{"issue":"3","key":"1054_CR16","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1002\/(SICI)1098-108X(199911)26:3<341::AID-EAT12>3.0.CO;2-9","volume":"26","author":"J Morton","year":"1999","unstructured":"Morton J, McLoughlin DM, Whiting S, Russell GF. Carnitine levels in patients with skeletal myopathy due to anorexia nervosa before and after refeeding. Int J Eat Disord. 1999;26(3):341\u20134.","journal-title":"Int J Eat Disord"},{"issue":"4","key":"1054_CR17","first-page":"162","volume":"167","author":"AD Fotino","year":"2015","unstructured":"Fotino AD, Sherma A. Patient with eating disorder, carnitine deficiency and dilated cardiomyopathy. J La State Med Soc. 2015;167(4):162\u20134.","journal-title":"J La State Med Soc"},{"key":"1054_CR18","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. American Psychiatric Publishing; 2013.","DOI":"10.1176\/appi.books.9780890425596"},{"key":"1054_CR19","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Practice guideline for the treament of patients with eating disorders. 4th ed. American Psychiatric Publishing; 2023.","DOI":"10.1176\/appi.books.9780890424865"},{"issue":"5","key":"1054_CR20","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1093\/clinchem\/40.5.817","volume":"40","author":"M Takahashi","year":"1994","unstructured":"Takahashi M, Ueda S, Misaki H, Sugiyama N, Matsumoto K, Matsuo N, et al. Carnitine determination by an enzymatic cycling method with carnitine dehydrogenase. Clin Chem. 1994;40(5):817\u201321.","journal-title":"Clin Chem"},{"key":"1054_CR21","unstructured":"Japan Pediatric Society. Diagnostic and therapeutic guidelines for carnitine deficiency 2018: Japan Pediatric Society. 2018. In Japanese. https:\/\/www.jpeds.or.jp\/uploads\/files\/20181207_shishin.pdf. Accessed 28 Jan 2024."},{"issue":"2","key":"1054_CR22","doi-asserted-by":"publisher","first-page":"100","DOI":"10.3810\/pgm.2000.02.869","volume":"107","author":"DV Gopal","year":"2000","unstructured":"Gopal DV, Rosen HR. Abnormal findings on liver function tests. Interpreting results to narrow the diagnosis and establish a prognosis. Postgrad Med. 2000;107(2):100. 5\u20139, 13\u2009\u2013\u20094.","journal-title":"Postgrad Med"},{"key":"1054_CR23","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1186\/1751-0759-5-14","volume":"5","author":"K Kawai","year":"2011","unstructured":"Kawai K, Yamashita S, Yamanaka T, Gondo M, Morita C, Nozaki T, et al. The longitudinal BMI pattern and body composition of patients with anorexia nervosa who require urgent hospitalization: a case control study. Biopsychosoc Med. 2011;5:14.","journal-title":"Biopsychosoc Med"},{"issue":"2","key":"1054_CR24","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1515\/IJAMH.2004.16.2.131","volume":"16","author":"NH Golden","year":"2004","unstructured":"Golden NH, Meyer W. Nutritional rehabilitation of anorexia nervosa. Goals and dangers. Int J Adolesc Med Health. 2004;16(2):131\u201344.","journal-title":"Int J Adolesc Med Health"},{"issue":"5","key":"1054_CR25","doi-asserted-by":"publisher","first-page":"757","DOI":"10.1016\/0272-6386(95)90439-5","volume":"26","author":"WD Labonia","year":"1995","unstructured":"Labonia WD. L-carnitine effects on anemia in hemodialyzed patients treated with erythropoietin. Am J Kidney Dis. 1995;26(5):757\u201364.","journal-title":"Am J Kidney Dis"},{"issue":"26","key":"1054_CR26","doi-asserted-by":"publisher","first-page":"2395","DOI":"10.1016\/0024-3205(90)90483-8","volume":"47","author":"A Arduini","year":"1990","unstructured":"Arduini A, Rossi M, Mancinelli G, Belfiglio M, Scurti R, Radatti G, et al. Effect of L-carnitine and acetyl-L-carnitine on the human erythrocyte membrane stability and deformability. Life Sci. 1990;47(26):2395\u2013400.","journal-title":"Life Sci"},{"issue":"9","key":"1054_CR27","doi-asserted-by":"publisher","first-page":"2671","DOI":"10.1093\/ndt\/gfl155","volume":"21","author":"A Arduini","year":"2006","unstructured":"Arduini A, Bonomini M, Clutterbuck EJ, Laffan MA, Pusey CD. Effect of L-carnitine administration on erythrocyte survival in haemodialysis patients. Nephrol Dial Transpl. 2006;21(9):2671\u20132.","journal-title":"Nephrol Dial Transpl"},{"issue":"3","key":"1054_CR28","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1681\/ASN.V133708","volume":"13","author":"JM Hurot","year":"2002","unstructured":"Hurot JM, Cucherat M, Haugh M, Fouque D. Effects of L-carnitine supplementation in maintenance hemodialysis patients: a systematic review. J Am Soc Nephrol. 2002;13(3):708\u201314.","journal-title":"J Am Soc Nephrol"},{"issue":"4","key":"1054_CR29","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1177\/0148607111430227","volume":"36","author":"AD Macher","year":"2012","unstructured":"Macher AD, Palazuelos D, Maviglia SM. Fatty emaciation: a case report of suspected fat overload syndrome in oral refeeding. JPEN J Parenter Enter Nutr. 2012;36(4):481\u20134.","journal-title":"JPEN J Parenter Enter Nutr"},{"issue":"1","key":"1054_CR30","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1016\/0009-8981(77)90513-7","volume":"75","author":"L Khan","year":"1977","unstructured":"Khan L, Bamji MS. Plasma carnitine levels in children with protein-calorie malnutrition before and after rehabilitation. Clin Chim Acta. 1977;75(1):163\u20136.","journal-title":"Clin Chim Acta"},{"issue":"5","key":"1054_CR31","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1093\/tropej\/45.5.294","volume":"45","author":"H Alp","year":"1999","unstructured":"Alp H, Orbak Z, Akcay F, Tan H, Aksoy H. Plasma and urine carnitine levels and carnitine supplementation in children with malnutrition. J Trop Pediatr. 1999;45(5):294\u20136.","journal-title":"J Trop Pediatr"},{"issue":"3","key":"1054_CR32","doi-asserted-by":"publisher","first-page":"221","DOI":"10.3164\/jcbn.14-77","volume":"55","author":"J Iwamoto","year":"2014","unstructured":"Iwamoto J, Honda A, Miyamoto Y, Miyazaki T, Murakami M, Saito Y, et al. Serum carnitine as an independent biomarker of malnutrition in patients with impaired oral intake. J Clin Biochem Nutr. 2014;55(3):221\u20137.","journal-title":"J Clin Biochem Nutr"},{"key":"1054_CR33","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1192\/bjp.162.4.452","volume":"162","author":"CW Sharp","year":"1993","unstructured":"Sharp CW, Freeman CP. The medical complications of anorexia nervosa. Br J Psychiatry. 1993;162:452\u201362.","journal-title":"Br J Psychiatry"},{"issue":"8","key":"1054_CR34","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1002\/eat.20775","volume":"43","author":"J Dowman","year":"2010","unstructured":"Dowman J, Arulraj R, Chesner I. Recurrent acute hepatic dysfunction in severe anorexia nervosa. Int J Eat Disord. 2010;43(8):770\u20132.","journal-title":"Int J Eat Disord"},{"key":"1054_CR35","doi-asserted-by":"crossref","unstructured":"Tomita K, Haga H, Ishii G, Katsumi T, Sato C, Aso R et al. Clinical manifestations of liver injury in patients with anorexia nervosa. Hepatol Res. 2013.","DOI":"10.1111\/hepr.12202"},{"issue":"3","key":"1054_CR36","doi-asserted-by":"publisher","first-page":"840","DOI":"10.1053\/j.gastro.2008.05.055","volume":"135","author":"PE Rautou","year":"2008","unstructured":"Rautou PE, Cazals-Hatem D, Moreau R, Francoz C, Feldmann G, Lebrec D, et al. Acute liver cell damage in patients with anorexia nervosa: a possible role of starvation-induced hepatocyte autophagy. Gastroenterology. 2008;135(3):840\u20138. 8 e1-3.","journal-title":"Gastroenterology"},{"key":"1054_CR37","first-page":"749169","volume":"2013","author":"S Restellini","year":"2013","unstructured":"Restellini S, Spahr L, Rubbia Brandt L. Severe starvation-induced hepatocyte autophagy as a cause of acute liver injury in anorexia nervosa: a case report. Case Rep Hepatol. 2013;2013:749169.","journal-title":"Case Rep Hepatol"},{"issue":"1","key":"1054_CR38","doi-asserted-by":"publisher","first-page":"32","DOI":"10.2169\/internalmedicine.37.32","volume":"37","author":"Y Ozawa","year":"1998","unstructured":"Ozawa Y, Shimizu T, Shishiba Y. Elevation of serum aminotransferase as a sign of multiorgan-disorders in severely emaciated anorexia nervosa. Intern Med. 1998;37(1):32\u20139.","journal-title":"Intern Med"},{"issue":"16","key":"1054_CR39","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.2169\/internalmedicine.47.0824","volume":"47","author":"M Tsukamoto","year":"2008","unstructured":"Tsukamoto M, Tanaka A, Arai M, Ishii N, Ohta D, Horiki N, et al. Hepatocellular injuries observed in patients with an eating disorder prior to nutritional treatment. Intern Med. 2008;47(16):1447\u201350.","journal-title":"Intern Med"},{"issue":"3","key":"1054_CR40","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.clnu.2012.08.020","volume":"32","author":"M Hanachi","year":"2013","unstructured":"Hanachi M, Melchior JC, Crenn P. Hypertransaminasemia in severely malnourished adult anorexia nervosa patients: risk factors and evolution under enteral nutrition. Clin Nutr. 2013;32(3):391\u20135.","journal-title":"Clin Nutr"},{"issue":"2","key":"1054_CR41","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1016\/j.jpeds.2014.10.048","volume":"166","author":"JM Nagata","year":"2015","unstructured":"Nagata JM, Park KT, Colditz K, Golden NH. Associations of elevated liver enzymes among hospitalized adolescents with anorexia nervosa. J Pediatr. 2015;166(2):439\u201343. e1.","journal-title":"J Pediatr"},{"issue":"2","key":"1054_CR42","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1002\/eat.22436","volume":"49","author":"E Rosen","year":"2016","unstructured":"Rosen E, Sabel AL, Brinton JT, Catanach B, Gaudiani JL, Mehler PS. Liver dysfunction in patients with severe anorexia nervosa. Int J Eat Disord. 2016;49(2):151\u20138.","journal-title":"Int J Eat Disord"},{"issue":"1","key":"1054_CR43","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1159\/000152871","volume":"53","author":"H Karlic","year":"2008","unstructured":"Karlic H, Schuster D, Varga F, Klindert G, Lapin A, Haslberger A, et al. Vegetarian diet affects genes of oxidative metabolism and collagen synthesis. Ann Nutr Metab. 2008;53(1):29\u201332.","journal-title":"Ann Nutr Metab"},{"issue":"1\u20132","key":"1054_CR44","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1023\/A:1006826620218","volume":"180","author":"DJ Paulson","year":"1998","unstructured":"Paulson DJ. Carnitine deficiency-induced cardiomyopathy. Mol Cell Biochem. 1998;180(1\u20132):33\u20134.","journal-title":"Mol Cell Biochem"}],"updated-by":[{"DOI":"10.1186\/s40337-026-01567-0","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T00:00:00Z","timestamp":1773792000000}}],"container-title":["Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-024-01054-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40337-024-01054-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40337-024-01054-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T11:38:07Z","timestamp":1773833887000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s40337-024-01054-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,9]]},"references-count":44,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1054"],"URL":"https:\/\/doi.org\/10.1186\/s40337-024-01054-4","relation":{},"ISSN":["2050-2974"],"issn-type":[{"value":"2050-2974","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,9]]},"assertion":[{"value":"29 January 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 March 2026","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s40337-026-01567-0","URL":"https:\/\/doi.org\/10.1186\/s40337-026-01567-0","order":8,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Ethics Review Committee of the Nagoya University Graduate School of Medicine (2009\u2009\u2212\u20090853). Written informed consent was obtained from all participants.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"N. Ozaki has received research support or speakers\u2019 honoraria from, or has served as a joint researcher with, or a consultant to, Sumitomo Pharma, Eisai, Otsuka, KAITEKI, Mitsubishi Tanabe, Eli Lilly, Mochida, Daiichi-Sankyo, TSUMURA, Takeda, Meiji Seika Pharma, EA Pharma, Viatris, Ricoh, Nippon Boehringer Ingelheim, Lundbeck Japan, Nihon Medi-Physics, and Nippon Chemiphar, outside the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"97"}}