Relationships between Serum Adipokines, Insulin Levels, and Bone Density in Girls with Anorexia Nervosa

Misra, Madhusmita; Miller, Karen K.; Cord, Jennalee; Prabhakaran, Rajani; Herzog, David B.; Goldstein, Mark A.; Katzman, Debra K.; Klibanski, Anne

doi:10.1210/jc.2006-2855

Cited by 172 publications

(185 citation statements)

References 42 publications

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“…(11) In a small study of 38 girls aged 12 to 18 years, an inverse association was observed between adiponectin and BMD. (19) Taken together, these observations suggest that reduced adiponectin levels also might contribute to the positive association between fat mass and bone mass accrual in childhood. To examine this question further, in this study we investigated the relationship between adiponectin levels as measured in the ALSPAC cohort at age 9.9 years, fat mass, and indices of skeletal development.…”

Section: Introductionmentioning

confidence: 85%

Adiponectin and its association with bone mass accrual in childhood

Sayers

Timpson

Sattar

et al. 2010

Journal of Bone and Mineral Research

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Circulating adiponectin levels are inversely related to bone mineral density (BMD) in humans and animal models. Previous studies in humans have been confined largely to adult populations, and whether adiponectin influences bone mass accrual in childhood is unclear. We examined this question using the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort by investigating relationships between circulating adiponectin levels at a mean age of 9.9 years, indices of bone mass as measured by total-body dualenergy X-ray absorptiometry (DXA) at ages 9.9 and 15.5 years, and cortical bone parameters as measured by peripheral quantitative computed tomography (pQCT) of the midtibia at age 15.5 years. A total of 4927 children were included at age 9.9 years, of whom 97% and 90% of boys and girls, respectively, were in prepuberty or early puberty, as defined by Tanner stage 1-2. A total of 2754 children were included at age 15.5 years, of whom 95% and 97% of boys and girls, respectively, were in late puberty, as defined by Tanner stage 4-5. Circulating adiponectin was found to be related to fat mass, lean mass, and, to a lesser extent, height, so analyses were adjusted for these three variables to identify possible independent effects of adiponectin on bone development. Adiponectin was inversely related to totalbody-less-head bone mineral content (BMC; À3.0%), bone area (BA; À1.8%), BMC divided by BA (BMD; À4.8%), and BMC adjusted for BA by linear regression (aBMC; À5.6%), as measured at age 9.9 years (coefficients show change per doubling in adiponectin concentration, p < .001). Consistent with these results, inverse associations also were seen between adiponectin and cortical BMC (À4.8%) and cortical bone area (À4.7%), as measured by tibial pQCT at age 15.5 years (p < .001). Further pQCT results suggested that this inverse association of adiponectin with skeletal development predominantly involved a negative association with endosteal relative to periosteal expansion, as reflected by cortical thickness (À6.0%, p < .001). We conclude that, independent of fat mass, lean mass, and height, adiponectin is associated with lower bone mass in childhood predominantly owing to an influence on relative endosteal expansion. Since these associations were observed before and after puberty, this suggests that setting of adiponectin levels in midchildhood has the potential to exert long-term effects on bone strength and fracture risk. ß

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Section: Introductionmentioning

confidence: 85%

Adiponectin and its association with bone mass accrual in childhood

Sayers

Timpson

Sattar

et al. 2010

Journal of Bone and Mineral Research

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“…Girls with AN suffer from a considerable decrease of bone mass [8][9][10]12 [64], girls with AN exhibited a considerable increase of serum OPG. Misra et al [4] suggested that decreased levels of bone resorption markers in girls with AN might indicate a suppressive effect of elevated serum OPG on osteoclast activity and differentiation.…”

Section: Discussionmentioning

confidence: 97%

“…bone-specific alkaline phosphatase, OC, C-terminal cross-linked telopeptide of type I collagen a chain (CTx), N-terminal cross-linked telopeptide of type-I collagen type I collagen a chain (NTx) and/or deoxypyridinoline [9, 10, 21-23, 60, 61] correlating with a decrease in BMD and LP levels [9,10,23]. Several authors have determined OPG concentrations in girls with AN and found that, similar to young females with AN, the girls had elevated serum levels of this cytokine [4,8,21,22,61]. Our earlier investigations revealed that serum sRANKL was increased while the OPG/sRANKL ratio was significantly decreased [21,22,61].…”

Section: Prace Oryginalnementioning

confidence: 99%

“…Only a few of these studies have also assessed the relationships between the above mentioned adipose tissue hormones (or some of them) and BMD and/or bone metabolism in patients with AN [3-8, 53-55, 56, 66]. The same regards the relationships between LP and/or ADIPO, RES, VISF and bone status with a focus on possible interaction of cytokines of the RANKL/RANK/OPG system [4,8,55,56,66]. Several findings [4,8,56,66] indicate a relationship between LP and/or ADIPO and RES and bone status.…”

Section: Prace Oryginalnementioning

confidence: 99%

“…The disease leads to significant reduction of adipose tissue mass resulting in drastic slimness or even physical wasting (cachexia) [1,2]. Patients with AN not only exhibit somatic and psychic complications resulting from dramatic weight loss but also, quite frequently, imbalance of hormones -also adipose tissue hormones [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Metabolizm kostny, osteoprotegeryna i ligand receptora aktywatora czynnika jądrowego-kB a wybrane hormony tkanki tłuszczowej u dziewcząt z jadłowstrętem psychicznym

Ostrowska¹,

Ziora²,

Oświęcimska³

et al. 2014

Endokrynologia Polska

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

Misra

Golden

Katzman

2015

Intl J Eating Disorders

Self Cite

104

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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.

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Relationships between Serum Adipokines, Insulin Levels, and Bone Density in Girls with Anorexia Nervosa

Abstract: Adiponectin contributes significantly to the variability of bone density, and insulin contributes to bone turnover markers in adolescent girls.

Cited by 172 publications

References 42 publications

Adiponectin and its association with bone mass accrual in childhood

Adiponectin and its association with bone mass accrual in childhood

Metabolizm kostny, osteoprotegeryna i ligand receptora aktywatora czynnika jądrowego-kB a wybrane hormony tkanki tłuszczowej u dziewcząt z jadłowstrętem psychicznym

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

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