Bone health in adolescent girls with anorexia nervosa – a pilot study
Authors:
P. Kabíček 1; J. Běhounek 2; K. Jaššová 3; K. Bořecká 4; M. Bayer 5,1; M. Magner 1,6
Authors‘ workplace:
Pediatrická klinika 1. LF UK a Thomayerovy nemocnice, Praha
1; Klinika revmatologie a rehabilitace 3. LF UK a Thomayerovy nemocnice, Praha
2; Oddělení dětské psychiatrie, Thomayerova nemocnice, Praha
3; Oddělení klinické biochemie, Thomayerova nemocnice, Praha
4; Klinika dětí a dorostu 3. LF UK a Fakultní nemocnice Královské Vinohrady, Praha
5; Klinika pediatrie a dědičných poruch metabolismu 1. LF UK a VFN, Praha
6
Published in:
Čes-slov Pediat 2020; 75 (6): 332-336.
Category:
Overview
Objective: Anorexia nervosa (anorexia nervosa, AN) significantly affects the bone health. The aim of our study was to evaluate the parameters of bone metabolism in a group of Czech girls with AN.
Patients and methods: The group included 32 girls with AN. Bone Mineral Density (BMD) of the lumbar spine, hip area, hormonal profile (LH, estradiol), and bone turnover parameters (osteocalcin, P1NP, beta-CTx) were examined.
Results: The group included 32 girls with an average age of 15.2 years (range 11–17 years), the disease duration of 8.7 months (range 3–24 months), an average weight loss of 12 kg (2–36 kg). The mean Z-score in the lumbar spine was 0.08±1.40, in the hip 0.23±1.28, and the overall Z-score was 0.13±1.14. When comparing the group of girls with primary amenorrhea or girls with secondary amenorrhea lasting 0–5 months and the group of girls with amenorrhea lasting 6 months and longer, a statistically insignificant decrease in the lumbar spine, hip and combined BMD was observed. Laboratory examination of bone turnover showed a reduction in osteocalcin (81.8% <50 p., 12.5% <2.5 p.), P1NP (84.3% <50 p., 21.8% <2.5. p.), while beta-CTx (34,7% >97. p.) was increased, according to normal ranges for the given age. Both estradiol and LH levels were reduced (53.1% <18.4 pmol/l; and 50% <0.1 U/l, respectively). In girls with the lowest plasma estradiol concentrations (<18.4 pmol/l), statistically significantly lower absolute hip BMD values were found p=0.009.
Conclusion: The results of the study show that hormonal changes precede changes in bone metabolism, which may later manifest at the level of morphologically measurable.
Keywords:
anorexia nervosa – body mass index – adolescence – bone mineral density – osteokalcin – P1NP – osteoporosis – mental anorexia
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Labels
Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2020 Issue 6
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