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Effect of anorexia nervosa on bone metabolism


Authors: Čagalová Alžbeta 1;  Tichá Ubica 1;  Killinger Zdenko 2;  Podracká Udmila 1
Authors‘ workplace: Detská klinika LF UK a Národný ústav detských chorôb, Bratislava 1;  V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava 2
Published in: Clinical Osteology 2020; 25(1): 37-43
Category:

Overview

Anorexia nervosa is the third most common chronic illness in adolescent girls. Clinical symptoms develop most frequently during sexual maturity. It is a period, when deprivation of nutrients with hormonal dysregulation can disrupt bone formation with microarchitectonic and structural changes and decrease bone mineral density. Objective: The aim of this study was to evaluate bone metabolism and hormonal changes in girls with ano­re­xia nervosa. Patients and methods: There were 65 girls with anorexia nervosa between 10–18 years of age enrolled in this study. We divided the patients into 2 groups: Z-score BMI > -2 SD (A), Z-score BMI ≤ -2 SD (B). We evaluated disease and amenorrhea duration, body mass index, hormonal profile and bone metabolism parameters. We examined the bone mineral density using dual X-ray absorptiometry. The results were evaluated using mathema­tical – statistical methods. Results: In the lower weight group (B) were significantly lower serum concentration of phosphorus, gona­dotropins (LH, FSH), estradiol and IGF-1 and higher serum cortisol concentration, as well as significantly higher calciuria. Bone formation markers (PINP 1) as well as bone turnover marker – osteocalcin were significantly lower in girls with Z-score BMI ≤ -2 SD, while bone resorption marker – CTx did not differ between groups. Bone mine­ral density was decreased in 14 (21.5 %) of anorectic girls. Predictor of low spinal bone mineral density was duration of secondary amenorrhea. Conclusion: Nutritional deficiency in anorexia nervosa alters neuro­endocrine pathways that negatively affect bone tissue and suggest a unique osteopathic condition in anorexia nervosa patients.

Keywords:

anorexia nervosa – bone metabolism – bone mineral density – children – Hormones


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