Laurent Maïmoun1, Eric Renard2, Patrick Lefebvre3, Helena Bertet4, Pascal Philibert5, Maude Seneque6, Marie-Christine Picot7, Anne-Marie Dupuy5, Laura Gaspari8, Fayçal Ben Bouallègue9, Philippe Courtet6, Denis Mariano-Goulart9, Charles Sultan8, Sébastien Guillaume6. 1. PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Départment of Nuclear Médicine, CHU Montpellier, Montpellier, France. Electronic address: l-maimoun@chu-montpellier.fr. 2. Department of Endocrinology, Diabetes, Nutrition, CHU Montpellier, Montpellier, France; CIC INSERM 1411, Montpellier, France; Institut of Functional Genomics, CNRS INSERM, University of Montpellier, Montpellier, France. 3. Department of Endocrinology, Diabetes, Nutrition, CHU Montpellier, Montpellier, France. 4. Unit of Clinical Research and Epidemiology, CHU Montpellier, Montpellier, France. 5. Department of Biochemistry and Hormonology, CHU Montpellier, Montpellier, France. 6. Department of Emergency and Post-Emergency of Psychiatric, CHU Montpellier, University of Montpellier, INSERM, Montpellier, France. 7. CIC INSERM 1411, Montpellier, France; Unit of Clinical Research and Epidemiology, CHU Montpellier, Montpellier, France. 8. Unit of Paediatric Endocrinology and Gynecology, CHU Montpellier and University of Montpellier, Montpellier, France. 9. PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France; Départment of Nuclear Médicine, CHU Montpellier, Montpellier, France.
Abstract
OBJECTIVE: To evaluate the potentially protective effects of oral contraceptives (OC) on bone loss in a large population of young women with anorexia nervosa (AN). DESIGN: Cross-sectional study. SETTING: University hospital. PATIENT(S): Three hundred and five patients with AN (99 of them using OC) and 121 age-matched controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Areal bone mineral density (aBMD) evaluated by dual-energy X-ray absorptiometry and bone turnover markers, with leptin evaluated concomitantly. RESULT(S): Although the AN patients taking OC presented lower aBMD compared with the controls at all bone sites, the whole body excepted, their aBMD values were systematically higher than those of AN patients who were not taking OC for the whole body and the lumbar spine, femoral neck, hip, and radius. These differences persisted after multiple adjustments. Preservation of aBMD improved with longer durations of OC use and shorter delays between disease onset and the start of OC. Moreover, patients with the lowest body mass index showed the best bone tissue responses to OC. Bone formation markers were systematically lower in the two groups of patients with AN compared with the controls. The markers of bone resorption were normalized in AN patients using OC. CONCLUSION(S): Although OC use does not provide total protection of aBMD, our data suggest that OC might be prescribed for young women with AN to limit their bone loss.
OBJECTIVE: To evaluate the potentially protective effects of oral contraceptives (OC) on bone loss in a large population of young women with anorexia nervosa (AN). DESIGN: Cross-sectional study. SETTING: University hospital. PATIENT(S): Three hundred and five patients with AN (99 of them using OC) and 121 age-matched controls. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Areal bone mineral density (aBMD) evaluated by dual-energy X-ray absorptiometry and bone turnover markers, with leptin evaluated concomitantly. RESULT(S): Although the AN patients taking OC presented lower aBMD compared with the controls at all bone sites, the whole body excepted, their aBMD values were systematically higher than those of AN patients who were not taking OC for the whole body and the lumbar spine, femoral neck, hip, and radius. These differences persisted after multiple adjustments. Preservation of aBMD improved with longer durations of OC use and shorter delays between disease onset and the start of OC. Moreover, patients with the lowest body mass index showed the best bone tissue responses to OC. Bone formation markers were systematically lower in the two groups of patients with AN compared with the controls. The markers of bone resorption were normalized in AN patients using OC. CONCLUSION(S): Although OC use does not provide total protection of aBMD, our data suggest that OC might be prescribed for young women with AN to limit their bone loss.
Authors: Stacie H Fleischer; Annalisa K Freire; Katie Brown; Andrew Creer; Dennis L Eggett; Susan Fullmer Journal: Int J Environ Res Public Health Date: 2022-08-19 Impact factor: 4.614