Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence

Wiksten-Almströmer, Marianne; Hirschberg, Angelica Lindén; Hagenfeldt, Kerstin

doi:10.1080/00016340902846080

Cited by 19 publications

(6 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An evaluation of long-term (negative) effects on BMD in 87 women diagnosed with menstrual disorders during adolescence revealed a restrictive eating disorder at follow-up (six years after initial assessment) as the strongest predictor of low BMD, whereas a BMI > 22 and high physical activity appeared to be the most important counter-indicators [32]. Particularly with regard to bed rest, a pilot study on patients aged 13-21 years showed that limitation of physical activity during hospitalization for patients with AN is associated with suppressed bone formation and resorption and an imbalance in bone turnover [61].…”

Section: Discussionmentioning

confidence: 99%

Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

Schulze

Schuler

Schlamp

et al. 2010

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

Background and aimsThere still is a lack of prospective studies on bone mineral development in patients with a history of early onset Anorexia nervosa (AN). Therefore we assessed associations between bone mass accrual and clinical outcomes in a former clinical sample. In addition to an expected influence of regular physical activity and hormone replacement therapy, we explored correlations with nutritionally dependent hormones.Methods3-9 years (mean 5.2 ± 1.7) after hospital discharge, we re-investigated 52 female subjects with a history of early onset AN. By means of a standardized approach, we evaluated the general outcome of AN. Moreover, bone mineral content (BMC) and bone mineral density (BMD) as well as lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). In a substudy, we measured the serum concentrations of leptin and insulin-like growth factor-I (IGF-I).ResultsThe general outcome of anorexia nervosa was good in 50% of the subjects (BMI ≥ 17.5 kg/m2, resumption of menses). Clinical improvement was correlated with BMC and BMD accrual (χ2 = 5.62/χ2 = 6.65, p = 0.06 / p = 0.036). The duration of amenorrhea had a negative correlation with BMD (r = -.362; p < 0.01), but not with BMC. Regular physical activity tended to show a positive effect on bone recovery, but the effect of hormone replacement therapy was not significant. Using age-related standards, the post-discharge sample for the substudy presented IGF-I levels below the 5th percentile. IGF-I serum concentrations corresponded to the general outcome of AN. By contrast, leptin serum concentrations showed great variability. They correlated with BMC and current body composition parameters.ConclusionsOur results from the main study indicate a certain adaptability of bone mineral accrual which is dependent on a speedy and ongoing recovery. While leptin levels in the substudy tended to respond immediately to current nutritional status, IGF-I serum concentrations corresponded to the individual's age and general outcome of AN.

show abstract

Section: Discussionmentioning

confidence: 99%

Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

Schulze

Schuler

Schlamp

et al. 2010

Child Adolesc Psychiatry Ment Health

View full text Add to dashboard Cite

show abstract

“…Adolescence is a particularly critical time for developing anorexia nervosa, and BMD is lower in women developing anorexia nervosa during adolescence compared with those who develop this in adulthood, even when the duration of amenorrhea is comparable [4]. Recent studies corroborate these data and indicate that adult women with a history of menstrual dysfunction and restrictive eating disorders in adolescence have a high prevalence of low BMD [5]. These data speak to the permanent effects anorexia nervosa can have on adult bone mass throughout life, even if there is recovery.…”

Section: Impact Of Anorexia Nervosa On Bone Metabolismmentioning

confidence: 99%

Bone health in anorexia nervosa

Misra

Klibanski

2011

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

View full text Add to dashboard Cite

Purpose of review Anorexia nervosa is associated with low bone mineral density (BMD), concerning for an increased risk of fractures, and decreased bone accrual in adolescents, concerning for suboptimal peak bone mass. This review discusses causes of impaired bone health in anorexia nervosa and potential therapeutic strategies. Recent findings Low BMD in anorexia nervosa is consequent to decreased lean mass, hypogonadism, low insulin-like growth factor-1 (IGF-1), relative hypercortisolemia and alterations in hormones impacted by energy availability. Weight gain causes some improvement in bone accrual, but not to the extent observed in controls, and vitamin D supplementation does not increase BMD. Oral estrogen is not effective in increasing BMD, likely from IGF-1 suppressive effects. In contrast, transdermal estrogen replacement is effective in increasing bone accrual in adolescents with anorexia nervosa, although not to the extent seen in controls. Recombinant human IGF-1 increases bone formation in adolescents, and with oral estrogen increases BMD in adults with anorexia nervosa. Bisphosphonates increase BMD in adults, but not in adolescents, and should be used cautiously given their long half-life. Summary Further investigation is necessary to explore therapies for low BMD in anorexia nervosa. Weight gain is to be encouraged. Transdermal estrogen in adolescents, and bisphosphonates in adults, have a potential therapeutic role.

show abstract

“…In other words, weight may be maintained or gained on fewer calories than would otherwise be expected. This can make it difficult for athletes to achieve optimal body composition while loss of menses puts the individual at risk of developing significant health problems, particularly loss of bone mineral density (BMD) (Beals & Hill, 2006;Manore et al, 2007;Wiksten-Almströmer et al, 2009).…”

Section: Body Compositionmentioning

confidence: 99%

The Relationship Between Within-Day Energy Balance and Menstruation in Active Females

Friel

Benardot

2011

Medicine &Amp; Science in Sports &Amp; Exercise

View full text Add to dashboard Cite

show abstract

Reduced bone mineral density in adult women diagnosed with menstrual disorders during adolescence

Cited by 19 publications

References 35 publications

Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

Bone health in anorexia nervosa

The Relationship Between Within-Day Energy Balance and Menstruation in Active Females

Contact Info

Product

Resources

About