Aim To investigate development of refeeding hypophosphatemia during the refeeding period and the extent of the decrease in the serum phosphorus level among anorexia nervosa patients with severe malnutrition. Objective The accurate prediction of the severity of refeeding hypophosphatemia in patients with anorexia nervosa during acute treatment is of great importance. Although some predictors were found in previous reports, these studies used binominal data—the presence or absence of hypophosphatemia—as an outcome indicator but not the extent of serum phosphorus level decrease. It is crucial in clinical settings to predict the extent of the serum phosphorus level decrease as well as development of refeeding hypophosphatemia, in particular, for patients with severe malnutrition, who has a higher risk of death. Methods We investigated 63 admissions from 37 patients with anorexia nervosa who had severe malnutrition (admission body mass index 11.5 ± 1.6) and carried out a linear discriminant regression analysis for the development of refeeding hypophosphatemia. The extent of the decrease in the serum phosphorus level were investigated using multiple linear regression analysis. Explanatory variables included data upon admission (age, sex, body mass index, blood urea nitrogen to creatinine ratio, albumin, initial serum phosphorus level, anorexia nervosa type, i.e., restrictive or binge-purge) as well as treatment-related indicators (calorie intake, amount of phosphate administered, and rate of weight gain). Results Development of refeeding hypophosphatemia and a change in serum phosphorus levels were predicted by body mass index and elevated blood urea nitrogen to creatinine ratio. Conclusions Our study found that refeeding hypophosphatemia among patients with severe malnutrition was predicted by a lower body mass index and elevated blood urea nitrogen to creatinine ratio.

中文翻译：

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体重指数和血尿素氮与肌酐比值预测严重营养不良的神经性厌食症患者再喂养低磷血症

目的探讨重度营养不良的神经性厌食症患者再喂养期间再喂养低磷血症的发生情况及血清磷水平降低的程度。目的准确预测神经性厌食症患者急性治疗期间再喂养性低磷血症的严重程度具有重要意义。尽管在之前的报告中发现了一些预测因素，但这些研究使用二项式数据——低磷血症的存在或不存在——作为结果指标，而不是血清磷水平降低的程度。在临床环境中，预测血清磷水平降低的程度以及再喂养低磷血症的发展至关重要，特别是对于死亡风险较高的严重营养不良患者。方法 我们调查了 37 名患有严重营养不良（入院体重指数 11.5 ± 1.6）的神经性厌食症患者的 63 名入院患者，并对再喂养低磷血症的发展进行了线性判别回归分析。使用多元线性回归分析研究血清磷水平降低的程度。解释变量包括入院时的数据（年龄、性别、体重指数、血尿素氮与肌酐比值、白蛋白、初始血清磷水平、神经性厌食症类型，即限制性或暴饮暴食）以及治疗相关指标（卡路里摄入量、施用的磷酸盐量和体重增加率）。结果 通过体重指数和升高的血尿素氮与肌酐比值来预测再喂养低磷血症的发展和血清磷水平的变化。结论 我们的研究发现，重度营养不良患者再次进食低磷血症可通过较低的体重指数和升高的血尿素氮与肌酐比值进行预测。