Clin Osteol 2020; 25(1): 37-43

Effect of anorexia nervosa on bone metabolismReview articles

Čagalová Alžbeta1, Tichá Ubica1, Killinger Zdenko2, Podracká Udmila1
1 Detská klinika LF UK a Národný ústav detských chorôb, Bratislava
2 V. interná klinika LF UK a UNB, Nemocnica Ružinov, Bratislava

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

Received: February 18, 2020; Accepted: June 25, 2020; Published: June 11, 2020  Show citation

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Čagalová A, Ubica T, Killinger Z, Udmila P. Effect of anorexia nervosa on bone metabolism. Clinical Osteology. 2020;25(1):37-43.
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