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The Increased Risk for Autoimmune Diseases in Patients with Eating Disorders
Open accessAbstract
OBJECTIVE: Research suggests autoimmune processes to be involved in psychiatric disorders. We aimed to address the prevalence and incidence of autoimmune diseases in a large Finnish patient cohort with anorexia nervosa, bulimia nervosa, and binge eating disorder. METHODS: Patients (N = 2342) treated at the Eating Disorder Unit of Helsinki University Central Hospital between 1995 and 2010 were compared with general population controls (N = 9368) matched for age, sex, and place of residence. Data of 30 autoimmune diseases from the Hospital Discharge Register from 1969 to 2010 were analyzed using conditional and Poisson regression models. RESULTS: Of patients, 8.9% vs. 5.4% of control individuals had been diagnosed with one or more autoimmune disease (OR 1.7, 95% CI 1.5-2.0, P<0.001). The increase in endocrinological diseases (OR 2.4, 95% CI 1.8-3.2, P<0.001) was explained by type 1 diabetes, whereas Crohn's disease contributed most to the risk of gastroenterological diseases (OR 1.8, 95% CI 1.4-2.5, P<0.001). Higher prevalence of autoimmune diseases among patients with eating disorders was not exclusively due to endocrinological and gastroenterological diseases; when the two categories were excluded, the increase in prevalence was seen in the patients both before the onset of the eating disorder treatment (OR 1.5, 95% CI 1.1-2.1, P = 0.02) and at the end of the follow-up (OR 1.4, 95% CI 1.1-1.8, P = 0.01). CONCLUSIONS: We observed an association between eating disorders and several autoimmune diseases with different genetic backgrounds. Our findings support the link between immune-mediated mechanisms and development of eating disorders. Future studies are needed to further explore the risk of autoimmune diseases and immunological mechanisms in individuals with eating disorders and their family members.
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“Patients with eating disorders have been shown to have a greater risk of developing autoimmune diseases or conditions with an auto-inflammatory etiology [88].”
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1 retracted
Pfleiderer, A., Lagier, J., Armougom, F., Robert, C., Vialettes, B., & Raoult, D. (2013) · European Journal of Clinical Microbiology & Infectious Diseases · doi:10.1007/s10096-013-1900-2 · Cited by 158
RetractedDiagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369
Diagnostic and Statistical Manual of Mental Disorders, 5th ed.
Carter, M. J. (2014) · Therapeutic Recreation Journal · Cited by 15,154
The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders?
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S., Meier, M. H., Ramrakha, S., Shalev, I., Poulton, R., et al. (2014) · Clinical Psychological Science · doi:10.1177/2167702613497473 · Cited by 2,449
Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs
Cross-Disorder Group of the Psychiatric Genomics Consortium (2013) · Nature Genetics · doi:10.1038/ng.2711 · Cited by 2,263
Sex differences in the gut microbiome drive hormone-dependent regulation of autoimmunity
Markle, J. G. M., Frank, D. N., Mortin-Toth, S., Robertson, C. E., Feazel, L. M., Rolle-Kampczyk, U., von Bergen, M., McCoy, K. D., Macpherson, A. J., & Danska, J. S. (2013) · Science · doi:10.1126/science.1233521 · Cited by 2,025
Armougom, F., Henry, M., Vialettes, B., Raccah, D., & Raoult, D. (2009) · PLoS ONE · doi:10.1371/journal.pone.0007125 · Cited by 905
Depression in Rheumatoid Arthritis: A Systematic Review of the Literature With Meta-Analysis
Dickens, C. M., McGowan, L., Clark-Carter, D. D., & Creed, F. H. (2002) · Psychosomatic Medicine · doi:10.1097/00006842-200201000-00008 · Cited by 635
Benros, M. E., Nielsen, P. R., Nordentoft, M., Eaton, W. W., Dalton, S. O., & Mortensen, P. B. (2011) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.11030516 · Cited by 582
Autoimmune Diseases and Severe Infections as Risk Factors for Mood Disorders: A Nationwide Study
Benros, M. E., Waltoft, B. L., Nordentoft, M., Østergaard, S. D., Eaton, W. W., Krogh, J., & Mortensen, P. B. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.1111 · Cited by 572
Eating disorders in adolescent females with and without type 1 diabetes: cross sectional study
Jones, J. M. (2000) · BMJ · doi:10.1136/bmj.320.7249.1563 · Cited by 568
The “Perfect Storm” for Type 1 Diabetes
Vaarala, O., Atkinson, M. A., & Neu, J. (2008) · Diabetes · doi:10.2337/db08-0331 · Cited by 497
Self-citationMedical complications of anorexia nervosa and bulimia nervosa
Mitchell, J. E., & Crow, S. J. (2006) · Current Opinion in Psychiatry · doi:10.1097/01.yco.0000228768.79097.3e · Cited by 495
Eating problems in adolescents with Type 1 diabetes: a systematic review with meta‐analysis
Young, V., Eiser, C., Johnson, B., Brierley, S., Epton, T., Elliott, J., & Heller, S. R. (2012) · Diabetic Medicine · doi:10.1111/j.1464-5491.2012.03771.x · Cited by 397
A genome-wide association study of anorexia nervosa
Perica, V. B., Franklin, C. S., Floyd, J. A. B., Thornton, L. M., Huckins, L. M., Southam, L., Rayner, N. W., Tachmazidou, I., Klump, K. L., Treasure, J. L., et al. (2014) · Molecular Psychiatry · doi:10.1038/mp.2013.187 · Cited by 331
Self-citationAutoimmune diseases, bipolar disorder, and non-affective psychosis
Eaton, W. W., Pedersen, M. G., Nielsen, P. R., & Mortensen, P. B. (2010) · Bipolar Disorders · doi:10.1111/j.1399-5618.2010.00853.x · Cited by 262
Losing your nerves? Maybe it's the antibodies
Diamond, B., Huerta, P. T., Mina-Osorio, P., Kowal, C., & Volpe, B. T. (2009) · Nature Reviews Immunology · doi:10.1038/nri2529 · Cited by 247
Stress, Hypothalamic-Pituitary-Adrenal Axis and Eating Disorders
Lo Sauro, C., Ravaldi, C., Cabras, P. L., Faravelli, C., & Ricca, V. (2008) · Neuropsychobiology · doi:10.1159/000138912 · Cited by 215
Autoantibodies against neuropeptides are associated with psychological traits in eating disorders
Fetissov, S. O., Harro, J., Jaanisk, M., Järv, A., Podar, I., Allik, J., Nilsson, I., Sakthivel, P., Lefvert, A. K., & Hökfelt, T. (2005) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0507204102 · Cited by 152
GOEBEL-FABBRI, A. E. (2009) · Current Diabetes Reports · doi:10.1007/s11892-009-0023-8 · Cited by 146
Autoantibodies against α-MSH, ACTH, and LHRH in anorexia and bulimia nervosa patients
Fetissov, S. O., Hallman, J., Oreland, L., af Klinteberg, B., Grenbäck, E., Hulting, A.-L., & Hökfelt, T. (2002) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.222658699 · Cited by 140
The role of microbes and autoimmunity in the pathogenesis of neuropsychiatric illness
Hornig, M. (2013) · Current Opinion in Rheumatology · doi:10.1097/bor.0b013e32836208de · Cited by 138
Harboe, E., Tjensvoll, A. B., Maroni, S., Gøransson, L. G., Greve, O. J., Beyer, M. K., Herigstad, A., Kvaløy, J. T., & Omdal, R. (2009) · Annals of the Rheumatic Diseases · doi:10.1136/ard.2008.098301 · Cited by 124
Preliminary evidence that gonadal hormones organize and activate disordered eating
Klump, K. L., Gobrogge, K. L., PERKINS, P. S., THORNE, D., Sisk, C. L., & Breedlove, S. M. (2005) · Psychological Medicine · doi:10.1017/s0033291705006653 · Cited by 117
Medical morbidity in binge eating disorder
Bulik, C. M., & Reichborn‐Kjennerud, T. (2003) · International Journal of Eating Disorders · doi:10.1002/eat.10204 · Cited by 114
Suokas, J. T., Suvisaari, J., Gissler, M., Löfman, R., Linna, M. S., Raevuori, A., & Haukka, J. K. (2013) · Psychiatry Research · doi:10.1016/j.psychres.2013.07.042 · Cited by 109
Self-citationInvolvement of cytokines in eating disorders: a critical review of the human literature
Corcos, M., Guilbaud, O., Paterniti, S., Moussa, M., Chambry, J., Chaouat, G., Consoli, S. M., & Jeammet, P. (2003) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(02)00021-5 · Cited by 104
A high prevalence of organ-specific autoimmunity in patients with bipolar disorder
Padmos, R. C., Bekris, L. M., Knijff, E. M., Tiemeier, H. W., Kupka, R., Cohen, D., Nolen, W. A., Lernmark, Å., & Drexhage, H. A. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.07.003 · Cited by 99
McDermott, J. R., Leslie, F. C., D’Amato, M., Thompson, D., Grencis, R. K., & McLaughlin, J. T. (2005) · Gut · doi:10.1136/gut.2005.081752 · Cited by 90
Eating Pathology in Adolescents With Celiac Disease
Karwautz, A. F. K., Wagner, G., Berger, G., Sinnreich, U., Grylli, V., & Huber, W. D. (2008) · Psychosomatics · doi:10.1176/appi.psy.49.5.399 · Cited by 81
The new link between gut–brain axis and neuropsychiatric disorders
Fetissov, S. O., & Déchelotte, P. (2011) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e32834936e7 · Cited by 78
A genome-wide association study of anorexia nervosa
Perica, V. B., Franklin, C. S., Floyd, J. A. B., Thornton, L. M., Huckins, L. M., Southam, L., Rayner, N. W., Tachmazidou, I., Klump, K. L., Treasure, J. L., et al. (2014) · Utrecht University Repository (Utrecht University) · Cited by 74
Self-citationMales with anorexia nervosa: A controlled study of eating disorders in first‐degree relatives
Strober, M., Freeman, R., Lampert, C., Diamond, J., & Kaye, W. H. (2001) · International Journal of Eating Disorders · doi:10.1002/eat.1017 · Cited by 73
Psychiatric comorbidities in women with Celiac Disease
Arigo, D., Anskis, A. M., & Smyth, J. M. (2011) · Chronic Illness · doi:10.1177/1742395311417639 · Cited by 73
Ghrelin reactive autoantibodies in restrictive anorexia nervosa
Terashi, M., Asakawa, A., Harada, T., Ushikai, M., Coquerel, Q., Sinno, M. H., Déchelotte, P., Inui, A., & Fetissov, S. O. (2011) · Nutrition · doi:10.1016/j.nut.2011.01.002 · Cited by 66
Lammi, N., Blomstedt, P., Moltchanova, E. V., Eriksson, J. G., Tuomilehto, J. O., & Karvonen, M. (2008) · Diabetologia · doi:10.1007/s00125-008-0952-9 · Cited by 57
A case of anorexia nervosa with comorbid Crohn's disease: Beneficial effects of anti‐TNF‐α therapy?
Solmi, M., Santonastaso, P., Caccaro, R., & Favaro, A. (2013) · International Journal of Eating Disorders · doi:10.1002/eat.22153 · Cited by 44
Limone, P. P., Biglino, A., Bottino, F., Forno, B., Calvelli, P., Fassino, S., Berardi, C., Ajmone-Catt, P., Bertagna, A., Tarocco, R. P., et al. (2000) · Journal of Endocrinological Investigation · doi:10.1007/bf03343750 · Cited by 36
High frequency of HLA-Bw16 in patients with anorexia nervosa
Biederman, J., Rivinus, T. M., Herzog, D. B., Harmatz, J. S., Shanley, K., & Yunis, E. J. (1984) · American Journal of Psychiatry · doi:10.1176/ajp.141.9.1109 · Cited by 16
Altunay, İ. K., Demırcı, G. T., Ates, Kucukunal, Yılmaz, Karamustafalioglu, & Altuntas (2011) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s24165 · Cited by 11
[Anorexia nervosa and Crohn disease: diagnostic intricacies and difficulties. 3 cases].
Blanchet, C., & Luton, J. P. (2002) · PubMed · Cited by 10
Thyroid disease and abnormal thyroid function tests in women with eating disorders and depression.
Hall, R. C. W., Dunlap, P. K., Hall, R. C., Pacheco, C. A., Blakey, R. K., & Abraham, J. (1995) · PubMed · Cited by 8
Dalbeth, N., & Callan, M. (2002) · The Lancet · doi:10.1016/s0140-6736(02)11320-1 · Cited by 7
The prevalence of eating disorders in thyroid disease: A pilot study
Tiller, J., Macrae, A. D., Schmidt, U., Bloom, S. R., & Treasure, J. L. (1994) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)90058-2 · Cited by 7
Hyperthyroidism during refeeding in anorexia nervosa
Rayment, D., Asfaha, E. A., Babiker, A. M. I., & Jaffa, T. (2011) · International Journal of Eating Disorders · doi:10.1002/eat.20964 · Cited by 6
Lack of association between HLA antigens and anorexia nervosa
Kiss, A., Hajek-Rosenmayr, A., Haubenstock, A., Wiesnagrotzki, S., & Moser, G. (1988) · American Journal of Psychiatry · doi:10.1176/ajp.145.7.876 · Cited by 6
Lack of association between HLA antigens and bulimia
Kiss, A., Hajek-Rosenmayr, A., Wiesnagrotzki, S., Abatzi, T.-A., Sidl, R., Moser, G., & Haubenstock, A. (1989) · Biological Psychiatry · doi:10.1016/0006-3223(89)90255-2 · Cited by 4
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Cited by
Sorted by citations
Anorexia nervosa: aetiology, assessment, and treatment
Zipfel, S., Giel, K. E., Bulik, C. M., Hay, P., & Schmidt, U. H. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00356-9 · Cited by 907
Risk factors for eating disorders: findings from a rapid review
Barakat, S., McLean, S. A., Bryant, E., Le, A., Marks, P., Aouad, P., Barakat, S., Boakes, R. A., Brennan, L., Bryant, E., et al. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-022-00717-4 · Cited by 467
Bidirectional relationship between eating disorders and autoimmune diseases
Hedman, A. M., Breithaupt, L. E., Hübel, C., Thornton, L. M., Tillander, A., Norring, C. E. A., Birgegård, A., Larsson, H., Ludvigsson, J. F., Savendahl, L. S., et al. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12958 · Cited by 156
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Olguín, P., Fuentes, M., Gabler, G., Guerdjikova, A. I., Keck, P. E., & McElroy, S. L. (2016) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-016-0313-5 · Cited by 140
Examination of the shared genetic basis of anorexia nervosa and obsessive–compulsive disorder
Yılmaz, Z., Halvorsen, M., Bryois, J., Yu, D., Thornton, L. M., Zerwas, S. C., Micali, N., Moessner, R., Burton, C. L., Zai, G. C., et al. (2018) · Molecular Psychiatry · doi:10.1038/s41380-018-0115-4 · Cited by 140
Metadata
- Authors
- Raevuori, A., Haukka, J., Vaarala, O., Suvisaari, J. M., Gissler, M., Grainger, M., Linna, M. S., & Suokas, J. T.
- Affiliations
- University of Helsinki (FI)
- Finnish Institute for Health and Welfare (FI)
- Tampere University (FI)
- Helsinki University Hospital (FI)
- Corresponding author
- Raevuori, Anu
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-08-22
- Volume
- 9
- Issue
- 8
- Pages
- e104845
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4141740
- OpenAlex
- W2123349506
- Cited by
- 137
- References
- 47
- Citations by year
- 2026: 5 · 2025: 16 · 2024: 11 · 2023: 12 · 2022: 13 · 2021: 16 · 2020: 13 · 2019: 16 · 2018: 12 · 2017: 13 · 2016: 5 · 2015: 4 · 2014: 1
- FWCI
- 9.05
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Tampere University Institutional Repository (Tampere University) (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Työväentutkimus Vuosikirja (submittedVersion)
- Tampere University Institutional Repository (Tampere University) (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- Funders
- AstraZeneca
- Medical Research Council (MR/K006525/1)
- Cilag
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- autoimmune disease, eating disorders, anorexia nervosa, bulimia nervosa, binge eating disorder, type 1 diabetes, Crohn's disease, gastroenterological diseases, immune-mediated mechanisms, prevalence
- MeSH terms
- Adolescent, Adult, Feeding and Eating Disorders, Autoimmune Diseases, Female, Finland, Follow-Up Studies, Humans, Male, Middle Aged, Risk, Incidence, Prevalence, Case-Control Studies, Young Adult
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