Olfaction is a Marker of Severity but Not Diagnosis in Anorexia Nervosa: a Systematic Review and Meta-Analysis

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • Yiling Mai - , Southern Medical University (Author)
  • Xin Zhang - , Southern Medical University (Author)
  • Zetian Li - , Southern Medical University (Author)
  • Xiaohua Wu - , Southern Medical University (Author)
  • Baoer Zeng - , Southern Medical University (Author)
  • Yuan Fang - , Southern Medical University (Author)
  • Laiquan Zou - , Southern Medical University, TUD Dresden University of Technology (Author)
  • Jiubo Zhao - , Southern Medical University (Author)
  • Thomas Hummel - , Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Carl Gustav Carus Dresden, TUD Dresden University of Technology (Author)

Abstract

Researchers have examined if olfaction is a sensitive biomarker of anorexia nervosa, but considerable heterogeneity across studies makes it difficult to reach a consensus. This review and meta-analysis sought to clarify if olfaction is altered in individuals with anorexia nervosa and explore potential moderators of olfaction in this population. We performed quantitative and qualitative analyses of olfactory function in individuals with anorexia nervosa compared with healthy controls. A random effect model was used to estimate pooled effect sizes, and meta-regression was conducted to identify potential moderators. We found that individuals with anorexia nervosa had largely intact olfactory function compared with healthy controls in terms of threshold (g = −0.09, 95% confidence interval [CI] (−0.65,0.47), p = 0.757), identification (g = −0.06, 95% CI (−0.32,0.20), p = 0.642), and overall olfactory function (g = −0.47, 95% CI (−1.02,0.07), p = 0.090). Discrimination was different from control (g = −0.51, 95% CI (−0.97,-0.05), p = 0.029). However, after sensitivity analysis, the pooled effect size was nonsignificant in discrimination. Olfactory sensitivity covaried with anorexia nervosa severity, body mass index (BMI) positively moderated olfactory threshold score (β = 0.79, 95% CI (0.18,1.41), p = 0.020) in individuals with anorexia nervosa. Disease duration negatively moderated olfactory threshold score (β = −0.21, 95% CI (−0.40,-0.03), p = 0.034). The results suggest that olfaction is not a sensitive marker of anorexia nervosa diagnosis, but olfactory sensitivity may be a useful indicator of anorexia nervosa severity.

Details

Original languageEnglish
Pages (from-to)251-266
Number of pages16
JournalNeuropsychology Review
Volume30
Issue number2
Publication statusPublished - 1 Jun 2020
Peer-reviewedYes

External IDs

PubMed 32447593
ORCID /0000-0001-9713-0183/work/151982934

Keywords

Keywords

  • Anorexia nervosa, BMI, Marker, Meta-analysis, Olfactory function