Predictors of low bone density in young adolescent females with anorexia nervosa and other dieting disorders

2001 ◽  
Vol 30 (3) ◽  
pp. 245-251 ◽  
Author(s):  
J. M. Turner ◽  
M. K. Bulsara ◽  
B. M. McDermott ◽  
G. C. Byrne ◽  
R. L. Prince ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bone Density ◽  
Adolescent Females ◽  
Young Adolescent ◽  
Low Bone Density

Correlates of low bone density in females with anorexia nervosa

2002 ◽  
Vol 14 (4) ◽  
Author(s):  
Marcie Schneider ◽  
Martin Fisher ◽  
Stuart Weinerman ◽  
Martin Lesser
Keyword(s):  
Anorexia Nervosa ◽  
Bone Density ◽  
Low Bone Density

scholarly journals Anorexia nervosa and bone

2014 ◽  
Vol 221 (3) ◽  
pp. R163-R176 ◽  
Author(s):  
Madhusmita Misra ◽  
Anne Klibanski
Keyword(s):  
Anorexia Nervosa ◽  
Bone Density ◽  
Bone Mass ◽  
Bone Structure ◽  
Normal Weight ◽  
Reproductive Age ◽  
Adult Women ◽  
Fat Depots ◽  
Low Bone Density ◽  
Clinically Significant

Anorexia nervosa (AN) is a condition of severe low weight that is associated with low bone mass, impaired bone structure, and reduced bone strength, all of which contribute to increased fracture risk. Adolescents with AN have decreased rates of bone accrual compared with normal-weight controls, raising additional concerns of suboptimal peak bone mass and future bone health in this age group. Changes in lean mass and compartmental fat depots, and hormonal alterations secondary to nutritional factors contribute to impaired bone metabolism in AN. The best strategy to improve bone density is to regain weight and menstrual function. Oral estrogen–progesterone combinations are not effective in increasing bone density in adults or adolescents with AN, and transdermal testosterone replacement is not effective in increasing bone density in adult women with AN. However, physiological estrogen replacement as transdermal estradiol with cyclic progesterone does increase bone accrual rates in adolescents with AN to approximate that in normal-weight controls, leading to a maintenance of bone densityZ-scores. A recent study has shown that risedronate increases bone density at the spine and hip in adult women with AN. However, bisphosphonates should be used with great caution in women of reproductive age, given their long half-life and potential for teratogenicity, and should be considered only in patients with low bone density and clinically significant fractures when non-pharmacological therapies for weight gain are ineffective. Further studies are necessary to determine the best therapeutic strategies for low bone density in AN.

scholarly journals Hypercortisolemia Is Associated with Severity of Bone Loss and Depression in Hypothalamic Amenorrhea and Anorexia Nervosa

Endocrinology ◽  
2009 ◽  
Vol 150 (11) ◽  
pp. 5191-5192
Author(s):  
Elizabeth A. Lawson ◽  
Daniel Donoho ◽  
Karen K. Miller ◽  
Madhusmita Misra ◽  
Erinne Meenaghan ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bone Density ◽  
Bone Loss ◽  
Rating Scales ◽  
Mood Disturbance ◽  
Anxiety And Depression ◽  
Mineral Density ◽  
Hypothalamic Amenorrhea ◽  
Low Bone Density ◽  
Cortisol Levels

ABSTRACT Context: Anorexia nervosa (AN) and functional hypothalamic amenorrhea (HA) are associated with low bone density, anxiety, and depression. Women with AN and HA have elevated cortisol levels. Significant hypercortisolemia, as in Cushing’s disease, causes bone loss. It is unknown whether anxiety and depression and/or cortisol dysregulation contribute to low bone density in AN or HA. Objective: Ourobjective was to investigate whether hypercortisolemia is associated with bone loss and mood disturbance in women with HA and AN. Design and Setting: We conducted a cross-sectional study in a clinical research center. Participants: We studied 52 women [21 healthy controls (HC), 13 normal-weight women with functional HA, and 18 amenorrheic women with AN]. Outcome Measures: Serum samples were measured every 20 min for 12 h overnight and pooled for average cortisol levels. Bone mineral density (BMD) was assessed by dual-energy x-ray absorptiometry (DXA) at anteroposterior and lateral spine and hip. Hamilton Rating Scales for Anxiety (HAM-A) and Depression (HAM-D) were administered. Results: BMD was lower in AN and HA than HC at all sites and lower in AN than HA at the spine. On the HAM-D and HAM-A, AN scored higher than HA, and HA scored higher than HC. Cortisol levels were highest in AN, intermediate in HA, and lowest in HC. HAM-A and HAM-D scores were associated with decreased BMD. Cortisol levels were positively associated with HAM-A and HAM-D scores and negatively associated with BMD. Conclusions: Hypercortisolemia is a potential mediator of bone loss and mood disturbance in these disorders.

Correlates of low bone density in females with anorexia nervosa

1996 ◽  
Vol 18 (2) ◽  
pp. 115 ◽  
Author(s):  
Marcie Schneider ◽  
Martin Fisher ◽  
Stuart Weinerman ◽  
Martin Lesser
Keyword(s):  
Anorexia Nervosa ◽  
Bone Density ◽  
Low Bone Density

Evaluation and Treatment of Low Bone Density in Anorexia Nervosa

2002 ◽  
Vol 5 (6) ◽  
pp. 298-308 ◽  
Author(s):  
Madhusmita Misra ◽  
Anne Klibanski
Keyword(s):  
Anorexia Nervosa ◽  
Bone Density ◽  
Low Bone Density

Bone health in adolescent females with anorexia nervosa may be preserved by high lean mass

2019 ◽  
Author(s):  
Munier Nour ◽  
Chantelle Baril ◽  
Saija Kontulainen ◽  
Ayisha Kurji ◽  
Adam Baxter-Jones ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Lean Mass ◽  
Bone Health ◽  
Adolescent Females

Decreased Bone Density in Adolescent Girls With Anorexia Nervosa

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 440-447 ◽  
Author(s):  
Laura K. Bachrach ◽  
David Guido ◽  
Debra Katzman ◽  
Iris F. Litt ◽  
Robert Marcus
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Bone Density ◽  
Bone Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Whole Body ◽  
Mineral Density ◽  
Control Subjects

Osteoporosis develops in women with chronic anorexia nervosa. To determine whether bone mass is reduced in younger patients as well, bone density was studied in a group of adolescent patients with anorexia nervosa. With single- and dual-photon absorptiometry, a comparison was made of bone mineral density of midradius, lumbar spine, and whole body in 18 girls (12 to 20 years of age) with anorexia nervosa and 25 healthy control subjects of comparable age. Patients had significantly lower lumbar vertebral bone density than did control subjects (0.830 ± 0.140 vs 1.054 ± 0.139 g/cm2) and significantly lower whole body bone mass (0.700 ± 0.130 vs 0.955 ± 0.130 g/cm2). Midradius bone density was not significantly reduced. Of 18 patients, 12 had bone density greater than 2 standard deviations less than normal values for age. The diagnosis of anorexia nervosa had been made less than 1 year earlier for half of these girls. Body mass index correlated significantly with bone mass in girls who were not anorexic (P < .05, .005, and .0001 for lumbar, radius, and whole body, respectively). Bone mineral correlated significantly with body mass index in patients with anorexia nervosa as well. In addition, age at onset and duration of anorexia nervosa, but not calcium intake, activity level, or duration of amenorrhea correlated significantly with bone mineral density. It was concluded that important deficits of bone mass occur as a frequent and often early complication of anorexia nervosa in adolescence. Whole body is considerably more sensitive than midradius bone density as a measure of cortical bone loss in this illness. Low body mass index is an important predictor of this reduction in bone mass.

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