Anna Svedlund1,2, Cecilia Pettersson3, Bojan Tubic4, Lars Ellegård3, Anders Elfvin5,6, Per Magnusson7, Diana Swolin-Eide5,6. 1. Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. anna.svedlund@gu.se. 2. Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Department of Pediatrics, Gothenburg, Sweden. anna.svedlund@gu.se. 3. Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 4. Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 5. Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. 6. Region Västra Götaland, Sahlgrenska University Hospital, Queen Silvia Children's Hospital, Department of Pediatrics, Gothenburg, Sweden. 7. Department of Clinical Chemistry, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Abstract
INTRODUCTION: Anorexia nervosa (AN) increases the risk of impaired bone health, low areal bone mineral density (aBMD), and subsequent fractures. This prospective study investigated the long-term effects of bone and mineral metabolism on bone and biomarkers in 22 women with AN. MATERIALS AND METHODS: Body composition and aBMD were measured by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography. Total and free 25-hydroxyvitamin D (25OHD), C-terminal collagen cross-links (CTX), osteocalcin, bone-specific alkaline phosphatase (BALP), leptin, sclerostin, and oxidized/non-oxidized parathyroid hormone (PTH) were analyzed before and after 12 weeks of intensive nutrition therapy and again 3 years later. An age-matched comparison group of 17 healthy women was recruited for the 3-year follow-up. RESULTS: Body mass index (BMI) and fat mass increased from baseline to 3 years in women with AN. Sclerostin decreased during nutrition therapy and further over 3 years, indicating reduced bone loss. CTX was elevated at baseline and after 12 weeks but decreased over 3 years. BALP increased during nutrition therapy and stabilized over 3 years. Free 25OHD was stable during treatment but decreased over 3 years. Non-oxidized PTH was stable during treatment but increased over 3 years. Trabecular volumetric BMD in AN patients decreased during the first 12 weeks and over 3 years despite stable BMI and bone biomarkers implying increased BMD. CONCLUSION: Our findings highlight the importance of early detection and organized long-term follow-up of bone health in young women with a history of AN.
INTRODUCTION: Anorexia nervosa (AN) increases the risk of impaired bone health, low areal bone mineral density (aBMD), and subsequent fractures. This prospective study investigated the long-term effects of bone and mineral metabolism on bone and biomarkers in 22 women with AN. MATERIALS AND METHODS: Body composition and aBMD were measured by dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography. Total and free 25-hydroxyvitamin D (25OHD), C-terminal collagen cross-links (CTX), osteocalcin, bone-specific alkaline phosphatase (BALP), leptin, sclerostin, and oxidized/non-oxidized parathyroid hormone (PTH) were analyzed before and after 12 weeks of intensive nutrition therapy and again 3 years later. An age-matched comparison group of 17 healthy women was recruited for the 3-year follow-up. RESULTS: Body mass index (BMI) and fat mass increased from baseline to 3 years in women with AN. Sclerostin decreased during nutrition therapy and further over 3 years, indicating reduced bone loss. CTX was elevated at baseline and after 12 weeks but decreased over 3 years. BALP increased during nutrition therapy and stabilized over 3 years. Free 25OHD was stable during treatment but decreased over 3 years. Non-oxidized PTH was stable during treatment but increased over 3 years. Trabecular volumetric BMD in AN patients decreased during the first 12 weeks and over 3 years despite stable BMI and bone biomarkers implying increased BMD. CONCLUSION: Our findings highlight the importance of early detection and organized long-term follow-up of bone health in young women with a history of AN.
Authors: Nicola Veronese; Marco Solmi; Wanda Rizza; Enzo Manzato; Giuseppe Sergi; Paolo Santonastaso; Lorenza Caregaro; Angela Favaro; Christoph U Correll Journal: Int J Eat Disord Date: 2014-11-29 Impact factor: 4.861
Authors: S Grinspoon; E Thomas; S Pitts; E Gross; D Mickley; K Miller; D Herzog; A Klibanski Journal: Ann Intern Med Date: 2000-11-21 Impact factor: 25.391
Authors: L Idolazzi; M El Ghoch; R Dalle Grave; P V Bazzani; S Calugi; S Fassio; C Caimmi; O Viapiana; F Bertoldo; V Braga; M Rossini; D Gatti Journal: Eat Weight Disord Date: 2016-10-27 Impact factor: 4.652
Authors: Isabelle Legroux-Gérot; Jean Vignau; Michèle D'Herbomez; Francis Collier; Xavier Marchandise; Bernard Duquesnoy; Bernard Cortet Journal: Calcif Tissue Int Date: 2007-08-01 Impact factor: 4.333