{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T18:03:24Z","timestamp":1764785004954,"version":"3.41.2"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003669","name":"Korea Centers for Disease Control and Prevention","doi-asserted-by":"publisher","award":["2016-ER6310-00"],"award-info":[{"award-number":["2016-ER6310-00"]}],"id":[{"id":"10.13039\/501100003669","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2021R1A2C2009668"],"award-info":[{"award-number":["2021R1A2C2009668"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Extreme weight conditions in young women are associated with adverse health outcomes. Closely linked with extreme weight status, eating disorders (EDs) are associated with several medical complications and high mortality rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>The study aimed to investigate the biochemical, hematologic, and skeletal features of young Korean women with underweight (UW) and overweight\/obesity (OW) conditions, and patients with anorexia nervosa (AN) and bulimia nervosa (BN) compared to women with normal-weight (NW).<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A total of 808 women (mean age 22.3 \u00b1 3.4 years) were recruited for the study, including 144 with UW status [body mass index (BMI) &amp;lt; 18.5 kg\/m<jats:sup>2<\/jats:sup>], 364 with NW, 137 with OW or obesity (27 with obesity; BMI \u2265 25 kg\/m<jats:sup>2<\/jats:sup>), 63 patients with anorexia nervosa (AN), and 100 with bulimia nervosa (BN). We measured blood pressure and performed biochemical, hematologic and bone mineral density (BMD) evaluations at the lumbar and femoral neck.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Blood pressure and triiodothyronine levels were found to be lower in both ED groups and higher in the OW group, but no difference in the UW group, compared to the NW group. The aminotransferases and total cholesterol levels were higher in the ED and OW groups, compared to the NW group. Blood cell counts were decreased in the AN group, while increased in the OW group, compared to the NW group. Blood urea nitrogen was elevated in both ED groups. The UW and AN groups had lower BMD, whereas the OW group had higher BMD, compared to the NW group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings suggested that both ED groups were associated with decreases in the resting energy expenditure. OW status was associated with a risk of metabolic syndrome, and UW status with lower BMD in young women. Overall, the medical parameters in Korean patients with ED were similar to the patterns reported in Western samples in previous studies, with few exceptions such as potassium level in BN.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.941043","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T04:44:02Z","timestamp":1669351442000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Biochemical, hematologic, and skeletal features associated with underweight, overweight, and eating disorders in young Korean women: A population-based study"],"prefix":"10.3389","volume":"13","author":[{"given":"Zhen","family":"An","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung-Hee","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirihae","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youl-Ri","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1111\/tmi.12679","article-title":"Economic burden of underweight and overweight among adults in the Asia-Pacific region: a systematic review","volume":"21","author":"Hoque","year":"2016","journal-title":"TM IH."},{"journal-title":"Korea Health Statistics 2020. Korea National Health and Nutrition Examination Survey (KNHANES VIII-1)","year":"2020","key":"B2"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jsbmb.2021.105849","article-title":"Adipose tissue estrogen production and metabolism in premenopausal women","volume":"209","author":"Hetem\u00e4ki","year":"2021","journal-title":"J Steroid Biochem Mol Biol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1097\/00003081-198528030-00013","article-title":"Body weight and the initiation of puberty","volume":"28","author":"Baker","year":"1985","journal-title":"Clin Obstet Gynecol."},{"key":"B5","first-page":"135","article-title":"Types of reproductive disorders in underweight and overweight young females and correlations of respective hormonal changes with BMI","volume":"133","author":"Aladashvili-Chikvaidze","year":"2015","journal-title":"Iran J Reprod Med."},{"key":"B6","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1007\/s00774-018-0949-5","article-title":"The relationships between bone variables and physical fitness across the BMI spectrum in young adult women","volume":"37","author":"Al Rassy","year":"2019","journal-title":"J Bone Metab."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1177\/2047487320908983","article-title":"Obesity, overweight and risk for cardiovascular disease and mortality in young women","volume":"28","author":"Dikaiou","year":"2021","journal-title":"Eur J Prev Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"924","DOI":"10.4254\/wjh.v10.i12.924","article-title":"Body mass index and its effects on liver fat content in overweight and obese young adults by proton magnetic resonance spectroscopy technique","volume":"10","author":"Pasanta","year":"2018","journal-title":"World J Hepatol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1002\/eat.23444","article-title":"Introduction to a special issue on eating disorders in Asia","volume":"54","author":"Kim","year":"2021","journal-title":"Int J Eat Disord."},{"key":"B10","doi-asserted-by":"publisher","first-page":"362","DOI":"10.7739\/jkafn.2014.21.4.362","article-title":"Factors influencing eating problems among Korean university women","volume":"21","author":"Byun","year":"2014","journal-title":"J Korean Fund Nurs."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1073","DOI":"10.1176\/ajp.152.7.1073","article-title":"Mortality in anorexia nervosa","volume":"152","author":"Sullivan","year":"1995","journal-title":"Am J Psychiatr."},{"volume-title":"Diagnostic and statistical manual of mental disorders","year":"2013","key":"B12"},{"key":"B13","doi-asserted-by":"publisher","first-page":"333","DOI":"10.3949\/ccjm.88a.20168","article-title":"Medical complications of bulimia nervosa","volume":"88","author":"Nitsch","year":"2021","journal-title":"Clevel Clin J Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"625","DOI":"10.1016\/j.psym.2020.06.020","article-title":"Medical complications of anorexia nervosa","volume":"61","author":"Cass","year":"2020","journal-title":"Psychosomatics."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s40337-015-0044-4","article-title":"Bulimia Nervosa\u2013medical complications","volume":"3","author":"Mehler","year":"2015","journal-title":"J Eat Disord."},{"key":"B16","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.amjmed.2015.06.031","article-title":"Medical complications of anorexia nervosa and bulimia","volume":"129","author":"Westmoreland","year":"2016","journal-title":"Am J Med."},{"key":"B17","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1017\/S1121189X00000956","article-title":"Eating disorders and obesity: two sides of the same coin?","volume":"18","author":"Day","year":"2009","journal-title":"Epidemiol Psychiatr Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"37","DOI":"10.4103\/0019-5545.148516","article-title":"A comparison of eating disorder patients in India and Australia","volume":"57","author":"Lal","year":"2015","journal-title":"Indian J Psychiatr."},{"key":"B19","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1080\/07448480109596317","article-title":"Ethnic differences in eating disorder symptoms among college students: the confounding role of body mass index","volume":"49","author":"Arriaza","year":"2001","journal-title":"J Am Coll Health."},{"key":"B20","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1002\/eat.20142","article-title":"Ethnic differences in the prediction of eating and body image disturbances among female adolescent psychiatric inpatients","volume":"38","author":"White","year":"2005","journal-title":"Int J Eat Disord."},{"key":"B21","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1159\/000484525","article-title":"An evolutionary genetic perspective of eating disorders","volume":"106","author":"Mayhew","year":"2018","journal-title":"Neuroendocrinology."},{"key":"B22","doi-asserted-by":"publisher","first-page":"163","DOI":"10.2174\/1573400512666160216234238","article-title":"Cultural and ethnic differences in eating disorders and disordered eating behaviors","volume":"12","author":"Levinson","year":"2016","journal-title":"Bentham Sci."},{"key":"B23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/erv.2900","article-title":"Negative emotion-related eating behaviours in young women with underweight status, overweight status, anorexia nervosa, and bulimia nervosa in Korea","volume":"2","author":"An","year":"2022","journal-title":"Eur Eat Disord Rev"},{"key":"B24","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1007\/s40519-018-0574-2","article-title":"Determinants of binge eating disorder among normal weight and overweight female college students in Korea","volume":"23","author":"Kim","year":"2018","journal-title":"Eat Weight Disord."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/nu14061315","article-title":"Factors Associated with Underweight, Overweight, and Eating Disorders in Young Korean Women: a population-based study","volume":"14","author":"Kim","year":"2022","journal-title":"Nutrients."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1001\/archinte.158.17.1855","article-title":"Executive Summary on clinical guidelines on the identification, evaluation and treatment of overweight and obesity in adults","volume":"158","year":"1998","journal-title":"Arch Intern Med"},{"volume-title":"The Asian-Pacific Perspective: Redefining Obesity and its Treatment","year":"2000","key":"B27"},{"key":"B28","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1002\/erv.2777","article-title":"A comparison of patients with anorexia nervosa and women who are constitutionally thin","volume":"28","author":"Bang","year":"2020","journal-title":"Eur Eat Disord Rev."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11154-021-09650-4","article-title":"Is constitutional thinness really different from anorexia nervosa? A systematic review and meta-analysis","volume":"2","author":"Bailly","year":"2021","journal-title":"Rev Endocr Metab Disord"},{"key":"B30","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.psyneuen.2017.06.015","article-title":"Differentiating constitutional thinness from anorexia nervosa in DSM 5 era","volume":"84","author":"Estour","year":"2017","journal-title":"Psychoneuroendocrinology."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2977","DOI":"10.1007\/s10620-017-4766-9","article-title":"Hepatic complications of anorexia nervosa","volume":"62","author":"Rosen","year":"2017","journal-title":"Dig Dis Sci."},{"key":"B32","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1002\/eat.22830","article-title":"Medical findings in 1,026 consecutive adult inpatient-residential eating disordered patients","volume":"51","author":"Mehler","year":"2018","journal-title":"Int J Eat Disord."},{"key":"B33","first-page":"709","article-title":"Mildly elevated liver transaminase levels: causes and evaluation","volume":"96","author":"Oh","year":"2017","journal-title":"Am Fam Physician."},{"key":"B34","doi-asserted-by":"publisher","first-page":"101","DOI":"10.4306\/pi.2013.10.2.101","article-title":"Medical findings in women with anorexia nervosa in a Korean population","volume":"10","author":"Kim","year":"2013","journal-title":"Psychiatry Investig."},{"key":"B35","doi-asserted-by":"publisher","first-page":"365","DOI":"10.4306\/jknpa.2013.52.5.365","article-title":"Medical findings in Korean Women with Bulimia Nervosa","volume":"52","author":"Kang","year":"2013","journal-title":"J Korean Neuropsychiatr Assoc."},{"key":"B36","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1002\/eat.23051","article-title":"Increased lipid and lipoprotein concentrations in anorexia nervosa: a systematic review and meta-analysis","volume":"52","author":"Hussain","year":"2019","journal-title":"Int J Eat Disord."},{"key":"B37","first-page":"280","article-title":"Lipid metabolism in anorexia nervosa","volume":"142","author":"Z\u00e1k","year":"2003","journal-title":"Casop\u00eds L\u00e9karu Cesk\u00fdch"},{"key":"B38","doi-asserted-by":"publisher","first-page":"443","DOI":"10.33549\/physiolres.930643","article-title":"Composition of plasma fatty acids and non-cholesterol sterols in anorexia nervosa","volume":"54","author":"Z\u00e1k","year":"2005","journal-title":"Physiol Res."},{"key":"B39","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1001\/jamapsychiatry.2019.2914","article-title":"Association of Bulimia Nervosa with long-term risk of cardiovascular disease and mortality among women","volume":"77","author":"Tith","year":"2020","journal-title":"Jama Psychiatr."},{"key":"B40","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1007\/s40519-018-0567-1","article-title":"Nervosa and heart disease: a systematic review","volume":"24","author":"Giovinazzo","year":"2019","journal-title":"Eat Weight Disord."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1305","DOI":"10.1038\/ejcn.2016.115","article-title":"Hematological complications in anorexia nervosa","volume":"70","author":"De Filippo","year":"2016","journal-title":"Eur J Clin Nutr."},{"key":"B42","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s00277-013-1672-x","article-title":"Hematological abnormalities in severe anorexia nervosa","volume":"92","author":"Sabel","year":"2013","journal-title":"Ann Hematol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"462","DOI":"10.1111\/ijcp.12801","article-title":"Relationship between underweight, bone mineral density and skeletal muscle index in premenopausal Korean women","volume":"70","author":"Lim","year":"2016","journal-title":"Int J Clin Pract."},{"key":"B44","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1001\/archinte.165.5.561","article-title":"Medical findings in outpatients with anorexia nervosa","volume":"165","author":"Miller","year":"2005","journal-title":"Arch Intern Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.bone.2019.115161","article-title":"Bone density status in a large population of patients with anorexia nervosa","volume":"131","author":"Workman","year":"2020","journal-title":"Bone."},{"key":"B46","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/nu8120769","article-title":"The association between weight gain\/restoration and bone mineral density in adolescents with anorexia nervosa: a systematic review","volume":"8","author":"El Ghoch","year":"2016","journal-title":"Nutrients."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1371\/journal.pone.0252487","article-title":"Association between obesity and risk of fracture, bone mineral density and bone quality in adults: a systematic review and meta-analysis","volume":"16","author":"Morin","year":"2021","journal-title":"PloS ONE."},{"key":"B48","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.puhe.2019.11.001","article-title":"Association of obesity with bone mineral density and osteoporosis in adults: a systematic review and meta-analysis","volume":"180","author":"Qiao","year":"2020","journal-title":"Public Health."},{"key":"B49","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1743-7075-2-9","article-title":"Differential effect of obesity on bone mineral density in White, Hispanic and African American women: a cross sectional study","volume":"2","author":"Castro","year":"2005","journal-title":"Nutr Metab."},{"key":"B50","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/ijerph13060544","article-title":"BMI and BMD: the potential interplay between obesity and bone fragility","volume":"13","author":"Palermo","year":"2016","journal-title":"Int J Environ Res."},{"key":"B51","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1177\/000456328702400104","article-title":"Biochemical-abnormalities in anorexia-nervosa and bulimia","volume":"24","author":"Mira","year":"1987","journal-title":"Ann Clin Biochem"},{"key":"B52","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1258\/acb.2011.011185","article-title":"The clinical biochemistry of anorexia nervosa","volume":"49","author":"Winston","year":"2012","journal-title":"Ann Clin Biochem."},{"key":"B53","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1176\/ajp.152.1.60","article-title":"Hypokalemia in outpatients with eating disorders","volume":"15","author":"Greenfeld","year":"1995","journal-title":"Am J Psychiatr."}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.941043\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T04:44:07Z","timestamp":1669351447000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2022.941043\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,25]]},"references-count":53,"alternative-id":["10.3389\/fpsyt.2022.941043"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2022.941043","relation":{},"ISSN":["1664-0640"],"issn-type":[{"type":"electronic","value":"1664-0640"}],"subject":[],"published":{"date-parts":[[2022,11,25]]},"article-number":"941043"}}