In adolescents with anorexia nervosa the number of circulating blood cells associates with bone mineral density

Czech version

Authors: Čagalová Alžbeta ¹; Kovalčíková Gaál Alexandra ¹; Tichá Ubica ¹; Šebeková Katarína ²; Podracká Udmila ¹
Authors‘ workplace: Detská klinika Lekárskej fakulty Univerzity Komenského a Národného ústavu detských chorôb, Bratislava ¹; Ústav molekulárnej biomedicíny, Lekárska fakulta Univerzity Komenského, Bratislava ²
Published in: Čes-slov Pediat 2022; 77 (3): 158-165.
Category: Original Papers

Overview

Background: Anorexia nervosa (AN) is a serious psychosomatic disorder that develops especially in adolescence. Severe nutritional deprivation with disruption of the internal environment andhormonal dysregulation affects hematopoiesis and bone metabolism. The aim of this study was to determine whether there is an association between hematopoiesis disruption and reduced bone metabolism in girls with AN.

Methods: Twenty-five girls with AN (mean age 16.2 ± 1.0) and 13 healthy controls with normal weight (mean age 16.7 ± 1.2) were enrolled in the study. Blood counts and markers of bone metabolism were analysed using standard laboratory methods. Bone mineral density was examined by dual X-ray absorptiometry. The results were evaluated by standard mathematical and statistical methods.

Results: Blood cells counts and concentrations of markers of bone metabolism (phosphorus, ALP, P1NP, osteocalcin) were significantly lower in girls with AN than in healthy controls (p ≤ 0.05). The group with AN had significantly lower bone mineral density (BMD) and BMD Z-score in the left hip (p ≤ 0.05) and lower bone mineral content (BMC) in the total body less head measurement (TBLH, p ≤ 0.05). Bone metabolism markers (phosphorus, ALP, P1NP, osteocalcin) positively correlated with leukocyte and erythrocyte counts (p ≤ 0.05). Leukocyte count positively correlated with BMD in the left hip (r = 0.34; p ≤ 0.05). Lymphocyte and monocyte counts correlated with BMD and BMD Z-scores in all measured areas (p ≤ 0.05).

Conclusion: Our study confirmed a positive relationship between hematopoiesis and bone metabolism disruption in patients with AN. The reduction in the number of osteoblasts, which create a supportive microenvironment for hematopoietic stem cells, leads to a reduction in all analysed blood cells. We hypothesize that a decrease in the number of osteoblasts and hematopoietic cells in patients with AN is associated with an increase in the amount of adipose tissue in the bone marrow. Further study is needed to confirm this hypothesis. Additionally, longitudinal studies should determine the effect of weight changes on hematopoiesis and bone metabolism.

Keywords:

Hematopoiesis – bone metabolism – bone mineral density – eating disorder

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