Oxidative stress and antioxidant levels in patients with anorexia nervosa: A systematic review and exploratory meta-analysis

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#anorexia-nervosa #antioxidants #biomarkers #cross-sectional-studies #female

Oxidative stress and antioxidant levels in patients with anorexia nervosa: A systematic review and exploratory meta-analysis

Solmi et al., 2015 | Int J Eat Disord | Meta Analysis

Citation

Solmi Marco, Veronese Nicola, ... Correll Christoph U. Oxidative stress and antioxidant levels in patients with anorexia nervosa: A systematic review and exploratory meta-analysis. Int J Eat Disord. 2015-Nov;48(7):826-41. doi:10.1002/eat.22443

Abstract

OBJECTIVE: To systematically review and meta-analyze oxidative stress and antioxidant markers in anorexia nervosa (AN). METHODS: Electronic PubMed search from database inception until 12/31/2013. Out of 1062 hits, 29 studies comparing oxidative stress/antioxidant markers between patients with AN and healthy controls (HCs) with a total of 1,729 participants (AN = 895, HCs = 834) were eligible. Data about oxidative stress and antioxidant markers, independent of their source, were extracted. We calculated random effects standardized mean differences (SMDs) as effect size measures for outcomes reported in ≥5 studies; others were summarized descriptively. RESULTS: Compared to HCs, AN patients showed significantly higher apolipoprotein B (ApoB) levels (studies = 7; n = 551; SMD = 0.75; p = .0003, I(2)  = 74%), with higher age being associated with higher ApoB (Coefficient: 0.61 ± 0.15, p < .0001), whereas BMI (p = .15) and measurement method (p = .70) did not moderate the results. Serum albumin levels were similar between AN and HCs (studies = 13; n = 509; SMD =-0.19; 95%CI: -0.62 to 0.24; p = .38; I(2)  = 81%), with neither age (p = .84) nor BMI (p = .52) being significant moderators. Lower superoxide dismutase levels were reported in 2 studies, while findings for vitamin A and its metabolites were inconclusive. In single studies, patients with AN had significantly higher catalase and nitric oxide (NO) parameter levels (platelet NO, exhaled NO and nitrites), such as lower glutathione and free cysteine levels, compared to HCs. DISCUSSION: AN appears to be associated with some markers of increased oxidative stress. Additional research is needed to discern whether oxidative stress is a potential cause or effect of AN, and whether treatments improving oxidative stress could be useful in AN.

Key Findings

Compared to HCs, AN patients showed significantly higher apolipoprotein B (ApoB) levels (studies = 7; n = 551; SMD = 0.75; p = .0003, I(2)  = 74%), with higher age being associated with higher ApoB (Coefficient: 0.61 ± 0.15, p < .0001), whereas BMI (p = .15) and measurement method (p = .70) did not moderate the results. Serum albumin levels were similar between AN and HCs (studies = 13; n = 509; SMD =-0.19; 95%CI: -0.62 to 0.24; p = .38; I(2)  = 81%), with neither age (p = .84) nor BMI (p = .52)

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population an and healthy controls
Sample Size 895
Age Range See abstract
Condition stress

MeSH Terms

  • Anorexia Nervosa
  • Antioxidants
  • Biomarkers
  • Cross-Sectional Studies
  • Female
  • Healthy Volunteers
  • Humans
  • Oxidative Stress
  • Young Adult

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-a

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09