Inflammatory biomarkers and childhood maltreatment: A cluster analysis in patients with eating disorders

Abstract

Eating Disorders (EDs) are severe psychiatric disorders, with growing evidence pointing towards the role of childhood maltreatment (CM) influencing their onset, severity, and response to treatment. Preliminary evidence showed that CM could be associated with an elevation of inflammatory biomarkers across the different EDs. The objective of the study was to elucidate the interplay between CM, ED-specific psychopathology, and inflammatory biomarkers. The study involved 198 female participants, comprising 70 patients with anorexia nervosa (AN), 56 patients with bulimia nervosa (BN), and 72 healthy controls (HCs). K-means clustering was used to assess the hypothesis that latent clusters could be described between patients affected by EDs based on serum levels of inflammatory biomarkers alone (CRP, IL-6, suPAR). Additionally, the analysis included a comparison between patients with and without history of childhood maltreatment. Patients with AN exhibited significantly higher suPAR levels than HCs, regardless of the severity of psychopathology. A direct association between CM and elevated levels of inflammatory biomarkers, particularly CRP, IL-6, and suPAR were found. Cluster analysis identified two distinct populations among patients with EDs, with the group showing elevated inflammatory biomarkers likely to report more severe CM. Even though preliminary, the results of the present study support the existence of a biologically grounded "maltreated eco-phenotype" in EDs. The present study also reports results on CRP, IL-6 and suPAR, in patients with EDs. These findings might suggest future potential tailored treatments and interventions designed to target specific subgroups of patients, and potentially improving treatment efficacy.

Keywords: Anorexia nervosa; Bulimia nervosa; Cytokines; Early adverse experiences.