Effect of anorexia nervosa on bone metabolism
Authors:
Čagalová Alžbeta 1; Tichá Ubica 1; Killinger Zdenko 2; Podracká Udmila 1
Authors‘ workplace:
Detská klinika LF UK a Národný ústav detských chorôb, Bratislava
1; V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava
2
Published in:
Clinical Osteology 2020; 25(1): 37-43
Category:
Overview
Anorexia nervosa is the third most common chronic illness in adolescent girls. Clinical symptoms develop most frequently during sexual maturity. It is a period, when deprivation of nutrients with hormonal dysregulation can disrupt bone formation with microarchitectonic and structural changes and decrease bone mineral density. Objective: The aim of this study was to evaluate bone metabolism and hormonal changes in girls with anorexia nervosa. Patients and methods: There were 65 girls with anorexia nervosa between 10–18 years of age enrolled in this study. We divided the patients into 2 groups: Z-score BMI > -2 SD (A), Z-score BMI ≤ -2 SD (B). We evaluated disease and amenorrhea duration, body mass index, hormonal profile and bone metabolism parameters. We examined the bone mineral density using dual X-ray absorptiometry. The results were evaluated using mathematical – statistical methods. Results: In the lower weight group (B) were significantly lower serum concentration of phosphorus, gonadotropins (LH, FSH), estradiol and IGF-1 and higher serum cortisol concentration, as well as significantly higher calciuria. Bone formation markers (PINP 1) as well as bone turnover marker – osteocalcin were significantly lower in girls with Z-score BMI ≤ -2 SD, while bone resorption marker – CTx did not differ between groups. Bone mineral density was decreased in 14 (21.5 %) of anorectic girls. Predictor of low spinal bone mineral density was duration of secondary amenorrhea. Conclusion: Nutritional deficiency in anorexia nervosa alters neuroendocrine pathways that negatively affect bone tissue and suggest a unique osteopathic condition in anorexia nervosa patients.
Keywords:
anorexia nervosa – bone metabolism – bone mineral density – children – Hormones
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Clinical biochemistry Paediatric gynaecology Paediatric radiology Paediatric rheumatology Endocrinology Gynaecology and obstetrics Internal medicine Orthopaedics General practitioner for adults Radiodiagnostics Rehabilitation Rheumatology TraumatologyArticle was published in
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