nach oben

Erschienen in:

12.08.2022 | Original Article

Bone mass and biomarkers in young women with anorexia nervosa: a prospective 3-year follow-up study

verfasst von: Anna Svedlund, Cecilia Pettersson, Bojan Tubic, Lars Ellegård, Anders Elfvin, Per Magnusson, Diana Swolin-Eide

Erschienen in: Journal of Bone and Mineral Metabolism | Ausgabe 6/2022

Einloggen, um Zugang zu erhalten

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.

Jaite C, Hoffmann F, Glaeske G, Bachmann CJ (2013) Prevalence, comorbidities and outpatient treatment of anorexia and bulimia nervosa in German children and adolescents. Eat Weight Disord 18:157–165PubMedCrossRef

Legroux-Gérot I, Vignau J, D’Herbomez M, Collier F, Marchandise X, Duquesnoy B, Cortet B (2007) Evaluation of bone loss and its mechanisms in anorexia nervosa. Calcif Tissue Int 81:174–182PubMedCrossRef

Grinspoon S, Thomas E, Pitts S, Gross E, Mickley D, Miller K, Herzog D, Klibanski A (2000) Prevalence and predictive factors for regional osteopenia in women with anorexia nervosa. Ann Intern Med 133:790–794PubMedPubMedCentralCrossRef

Idolazzi L, El Ghoch M, Dalle Grave R, Bazzani PV, Calugi S, Fassio S, Caimmi C, Viapiana O, Bertoldo F, Braga V, Rossini M, Gatti D (2018) Bone metabolism in patients with anorexia nervosa and amenorrhoea. Eat Weight Disord 23:255–261PubMedCrossRef

Hung C, Muñoz M, Shibli-Rahhal A (2021) Anorexia nervosa and osteoporosis. Calcif Tissue Int. https://doi.org/10.1007/s00223-021-00826-3CrossRefPubMed

Shah NR, Braverman ER (2012) Measuring adiposity in patients: the utility of body mass index (BMI), percent body fat, and leptin. PLoS ONE 7:e33308PubMedPubMedCentralCrossRef

Chen XX, Yang T (2015) Roles of leptin in bone metabolism and bone diseases. J Bone Miner Metab 33:474–485PubMedCrossRef

Veronese N, Solmi M, Rizza W, Manzato E, Sergi G, Santonastaso P, Caregaro L, Favaro A, Correll CU (2015) Vitamin D status in anorexia nervosa: a meta-analysis. Int J Eat Disord 48:803–813PubMedCrossRef

Svedlund A, Pettersson C, Tubic B, Magnusson P, Swolin-Eide D (2017) Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy. Eur J Nutr 56:2061–2067PubMedCrossRef

10.

Giollo A, Idolazzi L, Caimmi C, Fassio A, Bertoldo F, Dalle Grave R, El Ghoch M, Calugi S, Bazzani PV, Viapiana O, Rossini M, Gatti D (2017) Vitamin D levels strongly influence bone mineral density and bone turnover markers during weight gain in female patients with anorexia nervosa. Int J Eat Disord 50:1041–1049PubMedCrossRef

11.

Powe CE, Ricciardi C, Berg AH, Erdenesanaa D, Collerone G, Ankers E, Wenger J, Karumanchi SA, Thadhani R, Bhan I (2011) Vitamin D-binding protein modifies the vitamin D-bone mineral density relationship. J Bone Miner Res 26:1609–1616PubMedCrossRef

12.

Mendel CM (1989) The free hormone hypothesis: a physiologically based mathematical model. Endocr Rev 10:232–274PubMedCrossRef

13.

Tsuprykov O, Chen X, Hocher CF, Skoblo R, Lianghong Y, Hocher B (2018) Why should we measure free 25(OH) vitamin D? J Steroid Biochem Mol Biol 180:87–104PubMedCrossRef

14.

Bhan I, Powe CE, Berg AH, Ankers E, Wenger JB, Karumanchi SA, Thadhani RI (2012) Bioavailable vitamin D is more tightly linked to mineral metabolism than total vitamin D in incident hemodialysis patients. Kidney Int 82:84–89PubMedPubMedCentralCrossRef

15.

Johnsen MS, Grimnes G, Figenschau Y, Torjesen PA, Almas B, Jorde R (2014) Serum free and bio-available 25-hydroxyvitamin D correlate better with bone density than serum total 25-hydroxyvitamin D. Scand J Clin Lab Invest 74:177–183PubMedCrossRef

16.

Hovatta I, Juhila J, Donner J (2010) Oxidative stress in anxiety and comorbid disorders. Neurosci Res 68:261–275PubMedCrossRef

17.

Galceran T, Lewis-Finch J, Martin KJ, Slatopolsky E (1984) Absence of biological effects of oxidized parathyroid hormone-(1–34) in dogs and rats. Endocrinology 115:2375–2378PubMedCrossRef

18.

Tepel M, Armbruster FP, Gron HJ, Scholze A, Reichetzeder C, Roth HJ, Hocher B (2013) Nonoxidized, biologically active parathyroid hormone determines mortality in hemodialysis patients. J Clin Endocrinol Metab 98:4744–4751PubMedCrossRef

19.

Solmi M, Veronese N, Manzato E, Sergi G, Favaro A, Santonastaso P, Correll CU (2015) Oxidative stress and antioxidant levels in patients with anorexia nervosa: a systematic review and exploratory meta-analysis. Int J Eat Disord 48:826–841PubMedCrossRef

20.

Pettersson C, Tubic B, Svedlund A, Magnusson P, Ellegård L, Swolin-Eide D, Forslund HB (2016) Description of an intensive nutrition therapy in hospitalized adolescents with anorexia nervosa. Eat Behav 21:172–178PubMedCrossRef

21.

American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edn, text revision). Washington, DC

22.

American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (5th edn). Washington, DC

23.

Tubić B, Pettersson C, Svedlund A, Forslund HB, Magnusson P, Swolin-Eide D (2016) Increased bone mineral content during rapid weight gain therapy in anorexia nervosa. Horm Metab Res 48:664–672PubMedCrossRef

24.

Svedlund A, Hallbook T, Magnusson P, Dahlgren J, Swolin-Eide D (2019) Prospective study of growth and bone mass in Swedish children treated with the modified Atkins diet. Eur J Paediatr Neurol 23:629–638PubMedCrossRef

25.

Crabtree NJ, Arabi A, Bachrach LK, Fewtrell M, El-Hajj Fuleihan G, Kecskemethy HH, Jaworski M, Gordon CM (2014) Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom 17:225–242PubMedCrossRef

26.

Neu CM, Manz F, Rauch F, Merkel A, Schoenau E (2001) Bone densities and bone size at the distal radius in healthy children and adolescents: a study using peripheral quantitative computed tomography. Bone 28:227–232PubMedCrossRef

27.

Lee PH, Macfarlane DJ, Lam TH, Stewart SM (2011) Validity of the international physical activity questionnaire short form (IPAQ-SF): a systematic review. Int J Behav Nutr Phys Act 8:115PubMedPubMedCentralCrossRef

28.

Moyer-Mileur LJ, Quick JL, Murray MA (2008) Peripheral quantitative computed tomography of the tibia: pediatric reference values. J Clin Densitom 11:283–294PubMedCrossRef

29.

Jenkins N, Black M, Paul E, Pasco JA, Kotowicz MA, Schneider HG (2013) Age-related reference intervals for bone turnover markers from an Australian reference population. Bone 55:271–276PubMedCrossRef

30.

Davies JH, Evans BA, Gregory JW (2005) Bone mass acquisition in healthy children. Arch Dis Child 90:373–378PubMedPubMedCentralCrossRef

31.

Lucas AR, Melton LJ 3rd, Crowson CS, O’Fallon WM (1999) Long-term fracture risk among women with anorexia nervosa: a population-based cohort study. Mayo Clin Proc 74:972–977PubMedCrossRef

32.

Soyka LA, Misra M, Frenchman A, Miller KK, Grinspoon S, Schoenfeld DA, Klibanski A (2002) Abnormal bone mineral accrual in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 87:4177–4185PubMedCrossRef

33.

Viapiana O, Gatti D, Dalle Grave R, Todesco T, Rossini M, Braga V, Idolazzi L, Fracassi E, Adami S (2007) Marked increases in bone mineral density and biochemical markers of bone turnover in patients with anorexia nervosa gaining weight. Bone 40:1073–1077PubMedCrossRef

34.

Wanby P, Brudin L, Von SP, Carlsson M (2020) Modestly degraded microarchitecture and high serum levels of osteopontin in Swedish females with anorexia nervosa. Eat Weight Disord 26:2165–2172PubMedPubMedCentralCrossRef

35.

Parfitt AM (1994) The two faces of growth: benefits and risks to bone integrity. Osteoporos Int 4:382–398PubMedCrossRef

36.

Misra M, Prabhakaran R, Miller KK, Goldstein MA, Mickley D, Clauss L, Lockhart P, Cord J, Herzog DB, Katzman DK, Klibanski A (2008) Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa-1. J Clin Endocrinol Metab 93:1231–1237PubMedCrossRef

37.

Biller BM, Saxe V, Herzog DB, Rosenthal DI, Holzman S, Klibanski A (1989) Mechanisms of osteoporosis in adult and adolescent women with anorexia nervosa. J Clin Endocrinol Metab 68:548–554PubMedCrossRef

38.

Faje AT, Fazeli PK, Katzman DK, Miller KK, Breggia A, Rosen CJ, Mendes N, Klibanski A, Misra M (2012) Sclerostin levels and bone turnover markers in adolescents with anorexia nervosa and healthy adolescent girls. Bone 51:474–479PubMedPubMedCentralCrossRef

39.

Swenne I, Stridsberg M (2012) Bone metabolism markers in adolescent girls with eating disorders and weight loss: effects of growth, weight trend, developmental and menstrual status. Arch Osteoporos 7:125–133PubMedCrossRef

40.

Eastell R, Szulc P (2017) Use of bone turnover markers in postmenopausal osteoporosis. Lancet Diabetes Endocrinol 5:908–923PubMedCrossRef

41.

Karageorgiou V, Furukawa TA, Tsigkaropoulou E, Karavia A, Gournellis R, Soureti A, Bellos I, Douzenis A, Michopoulos I (2020) Adipokines in anorexia nervosa: a systematic review and meta-analysis. Psychoneuroendocrinology 112:104485PubMedCrossRef

42.

Lawson EA, Miller KK, Bredella MA, Phan C, Misra M, Meenaghan E, Rosenblum L, Donoho D, Gupta R, Klibanski A (2010) Hormone predictors of abnormal bone microarchitecture in women with anorexia nervosa. Bone 46:458–463PubMedCrossRef

43.

Vidailhet M, Mallet E (2013) Vitamin D in childhood. Presse Med 42:1383–1390PubMedCrossRef

44.

Carlsson M, Brudin L, Wanby P (2018) Directly measured free 25-hydroxy vitamin D levels show no evidence of vitamin D deficiency in young Swedish women with anorexia nervosa. Eat Weight Disord 23:247–254PubMedCrossRef

45.

Caso JR, Graell M, Navalón A, MacDowell KS, Gutiérrez S, Soto M, Leza JC, Carrasco JL, Marsá MD (2020) Dysfunction of inflammatory pathways in adolescent female patients with anorexia nervosa. Prog Neuropsychopharmacol Biol Psychiatry 96:109727PubMedCrossRef

46.

Sempos CT, Heijboer AC, Bikle DD, Bollerslev J, Bouillon R, Brannon PM, De Luca HF, Jones G, Munns CF, Bilezikian JP, Giustina A, Binkley N (2018) Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in vitamin D. Br J Clin Pharmacol 84:2194–2207PubMedPubMedCentralCrossRef

47.

Schwartz JB, Gallagher JC, Jorde R, Berg V, Walsh J et al (2018) Determination of Free 25(OH)D concentrations and their relationships to total 25(OH)D in multiple clinical populations. J Clin Endocrinol Metab 103:3278–3288PubMedPubMedCentralCrossRef

Titel: Bone mass and biomarkers in young women with anorexia nervosa: a prospective 3-year follow-up study
verfasst von: Anna Svedlund
Cecilia Pettersson
Bojan Tubic
Lars Ellegård
Anders Elfvin
Per Magnusson
Diana Swolin-Eide
Publikationsdatum: 12.08.2022
Verlag: Springer Nature Singapore
Erschienen in: Journal of Bone and Mineral Metabolism / Ausgabe 6/2022
Print ISSN: 0914-8779
Elektronische ISSN: 1435-5604
DOI: https://doi.org/10.1007/s00774-022-01359-x

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Bone mass and biomarkers in young women with anorexia nervosa: a prospective 3-year follow-up study