{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T19:59:34Z","timestamp":1792612774295,"version":"4.5.0"},"reference-count":50,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2017,3,2]],"date-time":"2017-03-02T00:00:00Z","timestamp":1488412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Micronutrient status in Anorexia Nervosa (AN) has been poorly documented and previous data are often contradictory. We aimed to assess micronutrient status in a large population of AN patients. The relationships between micronutrient status and body composition were also determined. Anthropometric, biochemical parameters and body composition data were collected at referral in 153 patients with AN (28.5 \u00b1 11 years). At least one trace element deficit was observed in almost half of patients; the most frequent was selenium deficit (40% of patients). At least one vitamin deficit was observed in 45.7% of patients, mostly vitamin A and B9. Albumin, transthyretin and CRP were within normal range in most patients. No correlations were found between body composition and micronutrient status. Our study suggests that micronutrient status is often altered in AN patients, which may contribute to neuropsychiatric dysfunction. Monitoring of micronutrients and correction of deficits should be included in the routine care of AN patients.<\/jats:p>","DOI":"10.3390\/nu9030225","type":"journal-article","created":{"date-parts":[[2017,3,2]],"date-time":"2017-03-02T10:31:17Z","timestamp":1488450677000},"page":"225","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Micronutrient Status in 153 Patients with Anorexia Nervosa"],"prefix":"10.3390","volume":"9","author":[{"given":"Najate","family":"Achamrah","sequence":"first","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"},{"name":"Clinical Investigation Centre CIC 1404 INSERM, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo\u00efse","family":"Co\u00ebffier","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u00e8s","family":"Rimbert","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyne","family":"Charles","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Folope","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Petit","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"D\u00e9chelotte","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Grigioni","sequence":"additional","affiliation":[{"name":"Nutrition Department, Rouen University Hospital, 76183 Rouen, France"},{"name":"INSERM Unit 1073, 76183 Rouen, France"},{"name":"Institute for Research and Innovation in Biomedicine, Normandie Universit\u00e9, 76183 Rouen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2017,3,2]]},"reference":[{"key":"ref_1","first-page":"191","article-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM)","volume":"25","author":"Battle","year":"2013","journal-title":"Codas"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1007\/s11920-012-0282-y","article-title":"Epidemiology of eating disorders: Incidence, prevalence and mortality rates","volume":"14","author":"Smink","year":"2013","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1192\/bjp.173.1.11","article-title":"Excess mortality of mental disorder","volume":"173","author":"Harris","year":"1998","journal-title":"Br. J. Psychiatry"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1016\/j.diabet.2010.11.020","article-title":"Outcome in AN adult patients: A 13-year follow-up in 484 patients","volume":"37","author":"Rigaud","year":"2011","journal-title":"Diabetes Metab."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1176\/appi.ajp.160.2.242","article-title":"Childhood obsessive-compulsive personality traits in adult women with eating disorders: Defining a broader eating disorder phenotype","volume":"160","author":"Anderluh","year":"2003","journal-title":"Am. J. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/S0924-9338(00)00212-1","article-title":"Anxiety disorders in anorexia nervosa and bulimia nervosa: Co-morbidity and chronology of appearance","volume":"15","author":"Godart","year":"2000","journal-title":"Eur. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","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":"ref_8","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s40519-016-0264-x","article-title":"A systematic review of the health-related quality of life and economic burdens of anorexia nervosa, bulimia nervosa, and binge eating disorder","volume":"21","author":"Agh","year":"2016","journal-title":"Eat. Weight Disord."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1097\/MCO.0b013e32834936e7","article-title":"The new link between gut-brain axis and neuropsychiatric disorders","volume":"14","author":"Fetissov","year":"2011","journal-title":"Curr. Opin. Clin. Nutr. Metab. Care"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"16335","DOI":"10.1073\/pnas.0701471104","article-title":"Anorexia induced by activation of serotonin 5-HT4 receptors is mediated by increases in CART in the nucleus accumbens","volume":"104","author":"Jean","year":"2007","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_11","first-page":"456","article-title":"Zinc deficiency and eating disorders","volume":"50","author":"Humphries","year":"1989","journal-title":"J. Clin. Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"694","DOI":"10.1080\/07315724.1992.10718269","article-title":"Zinc status before and after zinc supplementation of eating disorder patients","volume":"11","author":"McClain","year":"1992","journal-title":"J. Am. Coll. Nutr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1801","DOI":"10.1093\/ajcn\/33.8.1801","article-title":"An evaluation of trace metals, vitamins, and taste function in anorexia nervosa","volume":"33","author":"Casper","year":"1980","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1002\/1098-108X(200012)28:4<451::AID-EAT14>3.0.CO;2-I","article-title":"Prevalence of thiamin deficiency in anorexia nervosa","volume":"28","author":"Winston","year":"2000","journal-title":"Int. J. Eat. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1002\/eat.1088","article-title":"Serum beta-carotene in anorexia nervosa patients: A case-control study","volume":"30","author":"Boland","year":"2001","journal-title":"Int. J. Eat. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1093\/ajcn\/42.6.1183","article-title":"Alterations in vitamin A and thyroid hormone status in anorexia nervosa and associated disorders","volume":"42","author":"Erdman","year":"1985","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1093\/ajcn\/50.5.940","article-title":"Vitamin and trace element status of women with disordered eating","volume":"50","author":"Mira","year":"1989","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1093\/ajcn\/84.4.698","article-title":"Nutrient intake in community-dwelling adolescent girls with anorexia nervosa and in healthy adolescents","volume":"84","author":"Misra","year":"2006","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1080\/10640266.2014.1000111","article-title":"Avoiding medical complications during the refeeding of patients with anorexia nervosa","volume":"23","author":"Sachs","year":"2015","journal-title":"Eat. Disord."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1002\/erv.2420","article-title":"Oxidative Stress and Antioxidant Levels in Patients with Anorexia Nervosa after Oral Re-alimentation: A Systematic Review and Exploratory Meta-analysis","volume":"24","author":"Solmi","year":"2016","journal-title":"Eur. Eat. Disord. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1016\/j.diabet.2010.10.007","article-title":"Changes in body composition during weight loss in obese subjects in the NUGENOB study: Comparison of bioelectrical impedance vs. dual-energy X-ray absorptiometry","volume":"37","author":"Verdich","year":"2011","journal-title":"Diabetes Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.clnu.2014.06.009","article-title":"Validity of predictive equations for resting energy expenditure according to the body mass index in a population of 1726 patients followed in a Nutrition Unit","volume":"34","author":"Jesus","year":"2015","journal-title":"Clin. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1080\/10640260902991202","article-title":"Serum albumin levels may not correlate with weight status in severe anorexia nervosa","volume":"17","author":"Narayanan","year":"2009","journal-title":"Eat. Disord."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1016\/j.clnu.2004.05.004","article-title":"Indicators of nutritional status in restricting-type anorexia nervosa patients: A 1-year follow-up study","volume":"23","author":"Nova","year":"2004","journal-title":"Clin. Nutr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/S0899-9007(96)00170-0","article-title":"Serum albumin distribution in early treated anorexia nervosa","volume":"12","author":"Smith","year":"1996","journal-title":"Nutrition"},{"key":"ref_26","first-page":"86","article-title":"Anorexia nervosa: Absence of sensitivity to nutritional protein markers. Study of 23 patients and comparison to a paired group with colonic Crohn\u2019s disease","volume":"140","author":"Rigaud","year":"1989","journal-title":"Ann. Med. Interne"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.nut.2004.08.022","article-title":"Sodium depletion and hemoconcentration: Overlooked complications in patients with anorexia nervosa?","volume":"21","author":"Caregaro","year":"2005","journal-title":"Nutrition"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1016\/S0899-9007(97)85152-0","article-title":"On serum albumin in anorexia nervosa","volume":"12","author":"Waterlow","year":"1996","journal-title":"Nutrition"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/1098-108X(200011)28:3<284::AID-EAT5>3.0.CO;2-G","article-title":"Assessment of macronutrient and micronutrient intake in women with anorexia nervosa","volume":"28","author":"Hadigan","year":"2000","journal-title":"Int. J. Eat. Disord."},{"key":"ref_30","first-page":"447","article-title":"The nutritional status of subjects with anorexia nervosa","volume":"57","author":"Thibault","year":"1987","journal-title":"Int. J. Vitam. Nutr. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1007\/s12020-014-0477-6","article-title":"Selenium: An element for life","volume":"48","author":"Duntas","year":"2015","journal-title":"Endocrine"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e194","DOI":"10.1007\/BF03325347","article-title":"Tumour necrosis factor alpha and oxidative stress as maintaining factors in the evolution of anorexia nervosa","volume":"17","author":"Agnello","year":"2012","journal-title":"Eat. Weight Disord."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1038\/sj.ejcn.1601772","article-title":"Decreased glutathione in patients with anorexia nervosa. Risk factor for toxic liver injury?","volume":"58","author":"Zenger","year":"2004","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1002\/(SICI)1098-108X(199901)25:1<99::AID-EAT12>3.0.CO;2-N","article-title":"Antioxidant status in anorexia nervosa","volume":"25","author":"Moyano","year":"1999","journal-title":"Int. J. Eat. Disord."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/j.pharep.2014.12.015","article-title":"Oxidative stress as an etiological factor and a potential treatment target of psychiatric disorders. Part 2. Depression, anxiety, schizophrenia and autism","volume":"67","author":"Smaga","year":"2015","journal-title":"Pharmacol. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2193","DOI":"10.3390\/nu7042193","article-title":"Antioxidant activity and nutritional status in anorexia nervosa: Effects of weight recovery","volume":"7","author":"Martin","year":"2015","journal-title":"Nutrients"},{"key":"ref_37","first-page":"721","article-title":"Zinc in patients with anorexia nervosa","volume":"153","author":"Roijen","year":"1991","journal-title":"Ugeskr. Laeger"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/0306-9877(79)90034-3","article-title":"The role of zinc in anorexia nervosa: Etiology and treatment","volume":"5","author":"Bakan","year":"1979","journal-title":"Med. Hypotheses"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1493S","DOI":"10.1093\/jn\/130.5.1493S","article-title":"Neurobiology of zinc-influenced eating behavior","volume":"130","author":"Shay","year":"2000","journal-title":"J. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1203\/00006450-197212000-00003","article-title":"Low levels of zinc in hair, anorexia, poor growth, and hypogeusia in children","volume":"6","author":"Hambidge","year":"1972","journal-title":"Pediatr. Res."},{"key":"ref_41","first-page":"63","article-title":"Zinc deficiency and childhood-onset anorexia nervosa","volume":"54","author":"Lask","year":"1993","journal-title":"J. Clin. Psychiatry"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1007\/BF02777794","article-title":"Anorexia nervosa responding to zinc supplementation: A case report","volume":"27","author":"Yamaguchi","year":"1992","journal-title":"Gastroenterol. Jpn."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1002\/1098-108X(199404)15:3<251::AID-EAT2260150308>3.0.CO;2-#","article-title":"Controlled trial of zinc supplementation in anorexia nervosa","volume":"15","author":"Birmingham","year":"1994","journal-title":"Int. J. Eat. Disord."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"226","DOI":"10.2174\/2212798411103030226","article-title":"Zinc as an appetite stimulator\u2014The possible role of zinc in the progression of diseases such as cachexia and sarcopenia","volume":"3","author":"Suzuki","year":"2011","journal-title":"Recent Pat. Food Nutr. Agric."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.1007\/BF03327573","article-title":"How does zinc supplementation benefit anorexia nervosa?","volume":"11","author":"Birmingham","year":"2006","journal-title":"Eat. Weight Disord."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/S0304-3940(02)00312-9","article-title":"Body image distortion reveals amygdala activation in patients with anorexia nervosa\u2014A functional magnetic resonance imaging study","volume":"326","author":"Seeger","year":"2002","journal-title":"Neurosci. Lett."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/S0925-4927(01)00093-2","article-title":"Abnormal neuronal network in anorexia nervosa studied with I-123-IMP SPECT","volume":"107","author":"Takano","year":"2001","journal-title":"Psychiatry Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"2575","DOI":"10.1210\/jc.2011-0243","article-title":"Bioavailability of vitamin D in malnourished adolescents with anorexia nervosa","volume":"96","author":"Divasta","year":"2011","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1002\/1098-108X(199511)18:3<257::AID-EAT2260180307>3.0.CO;2-Q","article-title":"Vitamin status of eating disorder patients: Relationship to clinical indices and effect of treatment","volume":"18","author":"Rock","year":"1995","journal-title":"Int. J. Eat. Disord."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1002\/eat.10249","article-title":"Persistence of nutritional deficiencies after short-term weight recovery in adolescents with anorexia nervosa","volume":"35","author":"Castro","year":"2004","journal-title":"Int. J. Eat. Disord."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/3\/225\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T18:29:32Z","timestamp":1760207372000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/9\/3\/225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,2]]},"references-count":50,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2017,3]]}},"alternative-id":["nu9030225"],"URL":"https:\/\/doi.org\/10.3390\/nu9030225","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,2]]}}}