Predictors of bone mineral density in adolescents with atypical anorexia nervosa

Kızılkan, Melis Pehlivantürk; Akgül, Sinem; Derman, Orhan; Kanbur, Nuray

doi:10.1007/s00774-021-01211-8

Cited by 10 publications

(11 citation statements)

References 22 publications

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Section: Discussioncontrasting

confidence: 58%

“…One interesting finding was that a history of overweight/obesity was not protective against deficits in integrity of the peripheral skeleton in women with atypical anorexia nervosa. This is in contrast to two studies that included adolescents with atypical anorexia nervosa in which a history of overweight/obesity was associated with higher areal BMD by DXA; a shorter duration of illness in these studies may have precluded the ability to see longer terms effects of weight trajectory on bone (Nagata et al, 2019; Pehlivanturk‐Kizilkan et al, 2021). Although it is generally thought that greater mechanical loading (i.e., weight‐bearing) on bone is protective, and adults with obesity have higher BMD by DXA than lean controls (Evans et al, 2015), research suggests that adults with obesity have lower lumbar spine BMD by CT compared to lean controls (Bredella et al, 2011; Janicka et al, 2007).…”

Section: Discussionmentioning

confidence: 76%

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Deficits in volumetric bone mineral density, bone microarchitecture, and estimated bone strength in women with atypical anorexia nervosa compared to healthy controls

Haines

Kimball

Dove

et al. 2023

Intl J Eating Disorders

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ObjectiveAnorexia nervosa is associated with low bone mineral density (BMD) and deficits in bone microarchitecture and strength. Low BMD is common in atypical anorexia nervosa, in which criteria for anorexia nervosa are met except for low weight. We investigated whether women with atypical anorexia nervosa have deficits in bone microarchitecture and estimated strength at the peripheral skeleton.MethodMeasures of BMD and microarchitecture were obtained in 28 women with atypical anorexia nervosa and 27 controls, aged 21–46 years.ResultsMean tibial volumetric BMD, cortical thickness, and failure load were lower, and radial trabecular number and separation impaired, in atypical anorexia nervosa versus controls (p < .05). Adjusting for weight, deficits in tibial cortical bone variables persisted (p < .05). Women with atypical anorexia nervosa and amenorrhea had lower volumetric BMD and deficits in microarchitecture and failure load versus those with eumenorrhea and controls. Those with a history of overweight/obesity or fracture had deficits in bone microarchitecture versus controls. Tibial deficits were particularly marked. Less lean mass and longer disease duration were associated with deficits in high‐resolution peripheral quantitative computed tomography (HR‐pQCT) variables in atypical anorexia nervosa.DiscussionWomen with atypical anorexia nervosa have lower volumetric BMD and deficits in bone microarchitecture and strength at the peripheral skeleton versus controls, independent of weight, and particularly at the tibia. Women with atypical anorexia nervosa and amenorrhea, less lean mass, longer disease duration, history of overweight/obesity, or fracture history may be at higher risk. This is salient as deficits in HR‐pQCT variables are associated with increased fracture risk.Public SignificanceAtypical anorexia nervosa is a psychiatric disorder in which psychological criteria for anorexia nervosa are met despite weight being in the normal range. We demonstrate that despite weight in the normal range, women with atypical anorexia nervosa have impaired bone density, structure, and strength compared to healthy controls. Whether this translates to an increased risk of incident fracture in this population requires further investigation.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 76%

Deficits in volumetric bone mineral density, bone microarchitecture, and estimated bone strength in women with atypical anorexia nervosa compared to healthy controls

Haines

Kimball

Dove

et al. 2023

Intl J Eating Disorders

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“…Studies of dual x-ray absorptiometry data have demonstrated patients with AAN have higher bone mineral density than patients with typical AN but lower than healthy controls [23,26,27]. One study of bone mineral density in adolescents with AAN estimated a 34.2% lifetime risk of low bone mineral density [28]. In addition to the influence of estrogen and testosterone on osteoblast and osteoclast activity, other hormones including growth hormone (GH), insulin-like growth factor-1 (IGF-1, which stimulates bone growth and mineral deposition), ghrelin (which stimulates bone formation), and leptin (which stimulates bone resorption) play a role in normal bone deposition and can be disrupted by inadequate dietary intake and resultant hormonal suppression, leading to increased bone resorption as well as decreased deposition [29].…”

Section: Skeletalmentioning

confidence: 99%

Medical complications and management of atypical anorexia nervosa

Golden

2022

J Eat Disord

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Atypical anorexia nervosa (AAN) is a new diagnosis in the 5th edition of the Diagnostic and Statistical Manual. Patients with AAN have been recognized to have similar, if not more severe, medical and psychological complications compared with patients with typical Anorexia Nervosa; yet studies on medical complications and optimal treatment of AAN are lacking. Here we review what is known regarding medical presentation and management of patients with AAN.

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“…Hastalık öncesi yüksek BKİ varlığının koruyucu olduğu hem başka bir çalışmamızda hem de Nagata ve ark.nın çalışmasında gösterilmiştir. 17,24 Öte yandan kilo kaybı süresinin, hızının ve miktarının kemik sağlığı üzerine olumsuz etkisi olduğu da bilinmektedir. 25 Kusma, laksatif kullanma, aşırı miktarlarda egzersiz yapmak da kemik sağlığını olumsuz etkilemektedir.…”

Section: Bulgularunclassified

Bone Health in Adolescents with Anorexia Nervosa and Atypical Anorexia Nervosa: A Retrospective Cross-sectional Study

KIZILKAN¹,

SABANCI²,

TORUN³

et al. 2022

Turkiye Klinikleri J Pediatr

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Predictors of bone mineral density in adolescents with atypical anorexia nervosa

Cited by 10 publications

References 22 publications

Deficits in volumetric bone mineral density, bone microarchitecture, and estimated bone strength in women with atypical anorexia nervosa compared to healthy controls

Deficits in volumetric bone mineral density, bone microarchitecture, and estimated bone strength in women with atypical anorexia nervosa compared to healthy controls

Medical complications and management of atypical anorexia nervosa

Bone Health in Adolescents with Anorexia Nervosa and Atypical Anorexia Nervosa: A Retrospective Cross-sectional Study

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