Regional Skeletal Bone Deficit in Female Adolescents with Anorexia Nervosa: Influence of the Degree of Malnutrition and Weight Recovery in a Two Year Longitudinal Study

Alvaro, Maria Teresa Garcia-De; Muñoz-Calvo, M.T.; Martínez, Guillermo; Barrios, Vicente; Hawkins, Federico; Argente, Jesús

doi:10.1515/jpem.2007.20.11.1223

Cited by 9 publications

(5 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…More explicitly considered - and this was replicated in other studies - clinical improvement correlated positively with both BMC and BMD [28,53]. …”

Section: Discussionmentioning

confidence: 53%

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

“…More explicitly considered - and this was replicated in other studies - clinical improvement correlated positively with both BMC and BMD [28,53]. …”

Section: Discussionmentioning

confidence: 53%

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

“…In a longitudinal case‐controlled study, Soyka et al showed that adolescent girls with AN prospectively followed for 12 months had persistently low BMD at follow‐up despite weight gain, while healthy adolescents continued to accrue bone . These findings, combined with those examining markers of bone turnover in AN (discussed later), suggest that adults with AN lose bone mass whereas adolescents with AN have reduced bone formation in addition to increased or decreased bone resorption. Studies evaluating adults who have recovered from adolescent‐onset AN demonstrate persistent deficits in BMD up to 21 years after full recovery from the eating disorder …”

Section: Impact Of Anorexia Nervosa On Bonementioning

confidence: 99%

“…In children and adolescents there is no specific threshold below which a fracture is more likely to occur, but there is an increasing body of knowledge associating low BMD with fractures. Multiple cross‐sectional and longitudinal studies have consistently shown reductions in BMD in AN, both in adults and in adolescents . Reduced bone mass is not limited to girls, but is also seen in boys with AN .…”

Section: Impact Of Anorexia Nervosa On Bonementioning

confidence: 99%

“…Multiple cross-sectional and longitudinal studies have consistently shown reductions in BMD in AN, both in adults 11,12 and in adolescents. [13][14][15][16][17][18][19][20][21][22][23] Reduced bone mass is not limited to girls, but is also seen in boys with AN. 24,25 Both cortical and trabecular bone sites are affected but there is preferential loss of trabecular bone which is more metabolically active and has a higher turnover rate.…”

Section: Effect Of Anorexia Nervosa On Dual Energy X-ray Absorptiometmentioning

confidence: 99%

See 1 more Smart Citation

State of the art systematic review of bone disease in anorexia nervosa

Misra

Golden

Katzman

2015

Intl J Eating Disorders

104

View full text Add to dashboard Cite

Objective Low bone mineral density (BMD) is a known consequence of anorexia nervosa (AN) and is particularly concerning during adolescence, a critical time for bone accrual. A comprehensive synthesis of available data regarding impaired bone health, its determinants, and associated management strategies in AN is currently lacking. This systematic review aims to synthesize information from key physiologic and prospective studies and trials, and provide a thorough understanding of impaired bone health in AN and its management. Method Search terms included “anorexia nervosa” AND “bone density” for the period 1995–2015, limited to articles in English. Papers were screened manually based on journal impact factor, sample size, age of participants, and inclusion of a control group. When necessary, we included seminal papers published before 1995. Results AN leads to low BMD, impaired bone quality and increased fracture risk. Important determinants are low lean mass, hypogonadism, IGF-1 deficiency, and alterations in other hormones that impact bone health. Weight gain and menses restoration are critical for improving bone outcomes in AN. Physiologic estrogen replacement as the transdermal patch was shown to increase bone accrual in one study in adolescent females with AN; however, residual deficits persist. Bisphosphonates are potentially useful in adults with AN. Discussion To date, evidence suggests that the safest and most effective strategy to improve bone health in AN is normalization of weight with restoration of menses. Pharmacotherapies that show promise include physiologic estradiol replacement (as the transdermal estradiol patch), and in adults, bisphosphonates. Further studies are necessary to determine the best strategies to normalize BMD in AN.

show abstract

“…Malnutrition is one of major factors of bone disorders. This has been reported for relatively healthy people with anorexia nervosa [1]. Risk of bone disorders is substantial in the cases of malnutrition for maintenance hemodialysis patients [2], kidney transplant recipients [3], and Parkinson's disease patients [4].…”

Section: Introductionmentioning

confidence: 76%

An Isotonic Drink containing Pacific cod (<em>Gadus macrocephalus</em>) Processing Waste Collagen Hydrolysate for Prevention of Bone and Cartilage Disorders

Zarubin¹,

Kharenko²,

Bredikhina³

et al. 2022

Preprint

View full text Add to dashboard Cite

Malnutrition is one of major factors of bone and cartilage disorders. Pacific cod (Gadus macrocephalus) processing waste is a cheap and highly promising source of bioactive substances, including collagen-derived peptides and amino acids, for bone and cartilage structure stabilization. Addition of these substances to a functional drink is one of the ways to achieve their fast intestinal absorption. Collagen hydrolysate was obtained via enzymatic hydrolysis, ultrafiltration, freeze-drying, and grinding to powder. The lyophilized hydrolysate was a light gray powder with high protein content (>90%), including collagen (about 85% of total protein) and a complete set of essential and non-essential amino acids. The hydrolysate was applicable as a protein food supply or a structure-forming food component due to presence of collagen fiber fragments. An isotonic fitness drink (osmolality 298.1 ± 2.1 mOsm/L) containing the hydrolysate and vitamin C as a cofactor in collagen biosynthesis was prepared. Addition of the hydrolysate did not adversely affect its organoleptic parameters. Production of such functional foods and drinks is one of the beneficial ways of fish processing waste utilization.

show abstract

Regional Skeletal Bone Deficit in Female Adolescents with Anorexia Nervosa: Influence of the Degree of Malnutrition and Weight Recovery in a Two Year Longitudinal Study

Abstract: Moderate malnutrition in AN induces loss of bone mass at the lumbar and femoral levels. Weight gain and resumption of menses increases bone mass, especially in the lumbar spine.

Cited by 9 publications

References 16 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

State of the art systematic review of bone disease in anorexia nervosa

An Isotonic Drink containing Pacific cod (<em>Gadus macrocephalus</em>) Processing Waste Collagen Hydrolysate for Prevention of Bone and Cartilage Disorders

Contact Info

Product

Resources

About