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Bulimia Nervosa and Risk of Cardiovascular Outcomes: A Longitudinal Matched Cohort Study in Taiwan.

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Title: Bulimia Nervosa and Risk of Cardiovascular Outcomes: A Longitudinal Matched Cohort Study in Taiwan.
Authors: Lin, Che‐Yin, Tseng, Mei‐Chih Meg, Chiou, Kuan‐Rau, Shao, Joni Yu‐Hsuan, Liu, Hung‐Yi
Source: International Journal of Eating Disorders. Aug2025, Vol. 58 Issue 8, p1523-1534. 12p.
Subjects: Bulimia, Cardiomyopathies, Myocardial ischemia, Research funding, Sex distribution, Veins, Cardiovascular diseases risk factors, Age distribution, Atherosclerosis, Heart failure, Descriptive statistics, Longitudinal method, Case-control method, Thromboembolism, Cardiac arrest, Data analysis software, Confidence intervals, Social classes, Urbanization, Disease incidence, Proportional hazards models, Regression analysis, Disease complications
Geographic Terms: Taiwan
Abstract: Objective: Bulimia nervosa (BN), a prevalent eating disorder characterized by recurrent binge–purge cycles, may contribute to long‐term cardiovascular (CV) complications. However, evidence regarding these outcomes remains limited. This study investigated CV risks in patients with BN and the risk trajectory across varying follow‐up periods by using a nationwide Taiwanese cohort. Methods: Data from the National Health Insurance Research Database (2010–2022) were analyzed. Patients with BN aged 10–59 years were matched with controls at a 1:10 ratio on the basis of sex, age, socioeconomic status, urbanization, and index year through propensity score matching. The composite CV outcomes included atherosclerosis, cardiac arrest, cardiomyopathy, conduction disorders, congestive heart failure, inflammatory heart diseases, ischemic heart diseases, stroke, valve diseases, and venous thromboembolism. Hazard ratios (HR) were estimated using Cox regression models adjusted for baseline psychiatric and physical comorbidities. Results: The cumulative incidence of composite CV outcomes among patients with BN (n = 11,682) was 10.0% after 10 years of follow‐up. Patients with BN demonstrated a modest but significantly increased risk of composite CV outcomes (adjusted HR [aHR] 1.13 [95% CI, 1.03–1.23]), specifically those with psychiatric comorbidities (aHR 1.15 [95% CI, 1.03–1.29]) and with psychiatric hospitalization (aHR, 1.81 [95% CI, 1.25–2.61]). The risks of composite CV outcomes progressively increased across most follow‐up intervals. Conclusion: Patients with BN exhibited a modest but persistently elevated CV risk. CV monitoring is particularly important for BN individuals with psychiatric comorbidities and those in need of psychiatric hospitalization for timely detection and management. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Bulimia Nervosa and Risk of Cardiovascular Outcomes: A Longitudinal Matched Cohort Study in Taiwan.
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  Data: <searchLink fieldCode="AR" term="%22Lin%2C+Che‐Yin%22">Lin, Che‐Yin</searchLink><br /><searchLink fieldCode="AR" term="%22Tseng%2C+Mei‐Chih+Meg%22">Tseng, Mei‐Chih Meg</searchLink><br /><searchLink fieldCode="AR" term="%22Chiou%2C+Kuan‐Rau%22">Chiou, Kuan‐Rau</searchLink><br /><searchLink fieldCode="AR" term="%22Shao%2C+Joni+Yu‐Hsuan%22">Shao, Joni Yu‐Hsuan</searchLink><br /><searchLink fieldCode="AR" term="%22Liu%2C+Hung‐Yi%22">Liu, Hung‐Yi</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Eating+Disorders%22">International Journal of Eating Disorders</searchLink>. Aug2025, Vol. 58 Issue 8, p1523-1534. 12p.
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  Data: <searchLink fieldCode="DE" term="%22Bulimia%22">Bulimia</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiomyopathies%22">Cardiomyopathies</searchLink><br /><searchLink fieldCode="DE" term="%22Myocardial+ischemia%22">Myocardial ischemia</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Sex+distribution%22">Sex distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Veins%22">Veins</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiovascular+diseases+risk+factors%22">Cardiovascular diseases risk factors</searchLink><br /><searchLink fieldCode="DE" term="%22Age+distribution%22">Age distribution</searchLink><br /><searchLink fieldCode="DE" term="%22Atherosclerosis%22">Atherosclerosis</searchLink><br /><searchLink fieldCode="DE" term="%22Heart+failure%22">Heart failure</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br /><searchLink fieldCode="DE" term="%22Case-control+method%22">Case-control method</searchLink><br /><searchLink fieldCode="DE" term="%22Thromboembolism%22">Thromboembolism</searchLink><br /><searchLink fieldCode="DE" term="%22Cardiac+arrest%22">Cardiac arrest</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Confidence+intervals%22">Confidence intervals</searchLink><br /><searchLink fieldCode="DE" term="%22Social+classes%22">Social classes</searchLink><br /><searchLink fieldCode="DE" term="%22Urbanization%22">Urbanization</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+incidence%22">Disease incidence</searchLink><br /><searchLink fieldCode="DE" term="%22Proportional+hazards+models%22">Proportional hazards models</searchLink><br /><searchLink fieldCode="DE" term="%22Regression+analysis%22">Regression analysis</searchLink><br /><searchLink fieldCode="DE" term="%22Disease+complications%22">Disease complications</searchLink>
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  Label: Geographic Terms
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Taiwan%22">Taiwan</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Bulimia nervosa (BN), a prevalent eating disorder characterized by recurrent binge–purge cycles, may contribute to long‐term cardiovascular (CV) complications. However, evidence regarding these outcomes remains limited. This study investigated CV risks in patients with BN and the risk trajectory across varying follow‐up periods by using a nationwide Taiwanese cohort. Methods: Data from the National Health Insurance Research Database (2010–2022) were analyzed. Patients with BN aged 10–59 years were matched with controls at a 1:10 ratio on the basis of sex, age, socioeconomic status, urbanization, and index year through propensity score matching. The composite CV outcomes included atherosclerosis, cardiac arrest, cardiomyopathy, conduction disorders, congestive heart failure, inflammatory heart diseases, ischemic heart diseases, stroke, valve diseases, and venous thromboembolism. Hazard ratios (HR) were estimated using Cox regression models adjusted for baseline psychiatric and physical comorbidities. Results: The cumulative incidence of composite CV outcomes among patients with BN (n = 11,682) was 10.0% after 10 years of follow‐up. Patients with BN demonstrated a modest but significantly increased risk of composite CV outcomes (adjusted HR [aHR] 1.13 [95% CI, 1.03–1.23]), specifically those with psychiatric comorbidities (aHR 1.15 [95% CI, 1.03–1.29]) and with psychiatric hospitalization (aHR, 1.81 [95% CI, 1.25–2.61]). The risks of composite CV outcomes progressively increased across most follow‐up intervals. Conclusion: Patients with BN exhibited a modest but persistently elevated CV risk. CV monitoring is particularly important for BN individuals with psychiatric comorbidities and those in need of psychiatric hospitalization for timely detection and management. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of International Journal of Eating Disorders is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1002/eat.24461
    Languages:
      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 12
        StartPage: 1523
    Subjects:
      – SubjectFull: Bulimia
        Type: general
      – SubjectFull: Cardiomyopathies
        Type: general
      – SubjectFull: Myocardial ischemia
        Type: general
      – SubjectFull: Research funding
        Type: general
      – SubjectFull: Sex distribution
        Type: general
      – SubjectFull: Veins
        Type: general
      – SubjectFull: Cardiovascular diseases risk factors
        Type: general
      – SubjectFull: Age distribution
        Type: general
      – SubjectFull: Atherosclerosis
        Type: general
      – SubjectFull: Heart failure
        Type: general
      – SubjectFull: Descriptive statistics
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Case-control method
        Type: general
      – SubjectFull: Thromboembolism
        Type: general
      – SubjectFull: Cardiac arrest
        Type: general
      – SubjectFull: Data analysis software
        Type: general
      – SubjectFull: Confidence intervals
        Type: general
      – SubjectFull: Social classes
        Type: general
      – SubjectFull: Urbanization
        Type: general
      – SubjectFull: Disease incidence
        Type: general
      – SubjectFull: Proportional hazards models
        Type: general
      – SubjectFull: Regression analysis
        Type: general
      – SubjectFull: Disease complications
        Type: general
      – SubjectFull: Taiwan
        Type: general
    Titles:
      – TitleFull: Bulimia Nervosa and Risk of Cardiovascular Outcomes: A Longitudinal Matched Cohort Study in Taiwan.
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            NameFull: Lin, Che‐Yin
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            NameFull: Tseng, Mei‐Chih Meg
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            NameFull: Chiou, Kuan‐Rau
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            NameFull: Shao, Joni Yu‐Hsuan
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            NameFull: Liu, Hung‐Yi
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            – D: 01
              M: 08
              Text: Aug2025
              Type: published
              Y: 2025
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              Value: 58
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            – TitleFull: International Journal of Eating Disorders
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