Julia Clarke1,2, Hugo Peyre3,4, Marianne Alison5, Anne Bargiacchi3, Coline Stordeur3, Priscilla Boizeau6, Grégor Mamou3, Sophie Guilmin Crépon5,7,8, Corinne Alberti8, Juliane Léger4,7, Richard Delorme3. 1. Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France. julia.c.clarke@gmail.com. 2. Université de Paris, Institute of Psychiatry and Neuroscience of Paris, INSERM U1266, Paris, France. julia.c.clarke@gmail.com. 3. Child and Adolescent Psychiatry Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France. 4. Université de Paris, INSERM UMR 1141, Paris, France. 5. Radiology Department, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Pediatric, Paris, France. 6. Unit of Clinical Epidemiology, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France. 7. Department of Pediatric Endocrinology and Diabetology & Reference centre for Growth and Development Endocrine diseases, Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Paris, France. 8. INSERM UMR-S 1123 ECEVE and CIC-EC 1426, Paris, France.
Abstract
BACKGROUND: Early-onset anorexia nervosa (EO-AN) represents a significant clinical burden to paediatric and mental health services. The impact of EO-AN on bone mineral abnormalities has not been thoroughly investigated due to inadequate control for pubertal status. In this study, we investigated bone mineral abnormalities in girls with EO-AN regardless of pubertal development stage. METHOD: We conducted a cross-sectional study of 67 girls with EO-AN (median age = 12.4 [10.9-13.7 years]) after a median duration of disease of 1.3 [0.6-2.0] years, and 67 healthy age-, sex-, pubertal status- matched control subjects. We compared relevant bone mineral parameters between groups: the total body bone mineral density [TB-BMD], the lumbar spine BMD [LS-BMD], the total body bone mineral content [TB-BMC] and the ratio of the TB-BMC to lean body mass [TB-BMC/LBM]. RESULTS: TB-BMD, TB-BMC, LS-BMD and TB-BMC/LBM were all significantly lower in patients with AN compared to controls. In the EO-AN group, older age, later pubertal stages and higher lean body mass were associated with higher TB-BMC, TB-BMD, and LS-BMD values. DISCUSSION: Girls with EO-AN displayed deficits in bone mineral content and density after adjustment for pubertal maturation. Age, higher pubertal stage and lean body mass were identified as determinants of bone maturation in the clinical population of patients with EO-AN. Bone health should be promoted in patients, specifically in those with an onset of disorder before 14 years old and with a delayed puberty.
BACKGROUND: Early-onset anorexia nervosa (EO-AN) represents a significant clinical burden to paediatric and mental health services. The impact of EO-AN on bone mineral abnormalities has not been thoroughly investigated due to inadequate control for pubertal status. In this study, we investigated bone mineral abnormalities in girls with EO-AN regardless of pubertal development stage. METHOD: We conducted a cross-sectional study of 67 girls with EO-AN (median age = 12.4 [10.9-13.7 years]) after a median duration of disease of 1.3 [0.6-2.0] years, and 67 healthy age-, sex-, pubertal status- matched control subjects. We compared relevant bone mineral parameters between groups: the total body bone mineral density [TB-BMD], the lumbar spine BMD [LS-BMD], the total body bone mineral content [TB-BMC] and the ratio of the TB-BMC to lean body mass [TB-BMC/LBM]. RESULTS:TB-BMD, TB-BMC, LS-BMD and TB-BMC/LBM were all significantly lower in patients with AN compared to controls. In the EO-AN group, older age, later pubertal stages and higher lean body mass were associated with higher TB-BMC, TB-BMD, and LS-BMD values. DISCUSSION: Girls with EO-AN displayed deficits in bone mineral content and density after adjustment for pubertal maturation. Age, higher pubertal stage and lean body mass were identified as determinants of bone maturation in the clinical population of patients with EO-AN. Bone health should be promoted in patients, specifically in those with an onset of disorder before 14 years old and with a delayed puberty.
Entities:
Keywords:
Anorexia nervosa; Bone mineral content; Bone mineral density; Early onset; Pubertal maturation
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