A scoping review mapping vitamin, mineral, and trace element status in anorexia nervosa across published clinical cohorts. The review synthesizes findings on zinc, selenium, iron, copper, and multiple vitamins in inpatient and outpatient populations with anorexia nervosa, documenting the high prevalence of trace element deficiencies and the paradoxical findings for iron status (preserved serum iron but disturbed ferritin and transferrin).
Key numbers
- Zinc deficiency prevalence: 64.3% in a 374-patient inpatient anorexia nervosa cohort (p. 8).
- Mean serum zinc in AN: 64.5 to 65.7 µg/dL versus clinical reference range 80 to 120 µg/dL (p. 8).
- Selenium deficiency prevalence: 40.6% in a 153-patient cohort; 53.6% (82 of 153 patients) applying a threshold of plasma selenium below 80 µg/L (p. 14).
- Selenium deficiency threshold used: plasma selenium below 80 µg/L, approximating the concentration required for optimal selenoprotein activity (p. 14).
- Iron status (318-woman outpatient cohort): low serum iron found in only 6.2%, whereas ferritin was often elevated and transferrin sometimes reduced (p. 13).
- Extreme iron dysregulation case: one severely malnourished woman with anorexia nervosa had hyperferritinemia with ferritin reaching 9,096 µg/L (p. 13).
- LOD/LOQ: not reported (scoping review of published cohorts; analytical specifications are in cited primary literature).
Methods (brief)
Scoping review following PRISMA-ScR guidelines. Databases searched: PubMed, Embase, and Web of Science. Inclusion criteria: studies in humans with anorexia nervosa reporting micronutrient or trace element status. The review covers vitamins, minerals, and trace elements; the excerpts above are specific to zinc, selenium, and iron. Because this is a review paper, LOD/LOQ and CRM data from primary cohort studies are not independently stated.
Evidence fitness
This source supports characterization of zinc deficiency prevalence (64.3%) and mean serum zinc levels in anorexia nervosa inpatient cohorts, selenium deficiency prevalence using the 80 µg/L plasma threshold, and the paradoxical iron status findings (preserved serum iron with disturbed ferritin and transferrin). The serum zinc reference range (80 to 120 µg/dL) and selenium deficiency threshold (80 µg/L plasma) cited on the target page are taken from this source. The extreme hyperferritinemia case (ferritin 9,096 µg/L) is cited as an example of disturbed iron regulation under severe malnutrition, not as a general population estimate. These data are specific to anorexia nervosa populations and should not be generalized to the general population for prevalence estimates.
Limitations
Scoping review; primary cohorts included are of variable design and sample size. The 374-patient cohort (zinc deficiency 64.3%) and the 153-patient cohorts (selenium deficiency) are single-cohort estimates from the reviewed literature and may not be generalizable beyond the AN inpatient setting. Iron status findings are from an outpatient cohort and reflect a population with specific medical care exposure. Ferritin interpretation in the context of inflammation and malnutrition is methodologically complex; the scoping review acknowledges this limitation.
Related evidence
Update history
No substantive edit history is available in this build. The full commit record is available in git.