ECTS2016 Poster Presentations Osteoporosis: pathophysiology and epidemiology (55 abstracts)
Bone metabolism in patients with anorexia nervosa and amenorrhea
Davide Gatti 1 , Luca Idolazzi 1 , Marwan el Ghoch 2 , Ombretta Viapiana 1 , Simona Calugi 2 , Maurizio Rossini 1 , Cristian Caimmi 1 , Vania Braga 1 , Giorgio Radetti 3 , Silvano Adami 1 & Riccardo Dalle Grave 2
1Rheumatology Unit, University of Verona, Verona, Italy; 2Department of Eating and Weight Disorders, Villa Garda Hospital, Garda, Verona, Italy; 3Department of Paediatrics, Regional Hospital, Bolzano, Italy.
Context: Anorexia nervosa (AN) occurs predominantly in females, most frequently during adolescence and it is generally associated with amenorrhoea. AN increases the risk for impaired bone health and for low bone mineral density (BMD) by a mechanism which has not been yet well defined.
Objective: The study purpose was to further characterize bone metabolism in AN with amenorrhoea, and so with oestrogen deficiency
Design: AN patients were compared with healthy females matched for age and with postmenopausal women as a model for oestrogen deficiency.
Study popultion: The study population included 81 females with AN: 48 young adults and 33 adolescents. All had amenorrhoea for at least 6 months and none of them had serum 25 OH vitamin D lower than 20 ng/ml. The control groups included age matched healthy young ladies (n=20), 17 healthy adolescents and 21 postmenopausal women.
Methods: We studied bone turnover markers, intact parathyroid hormone, 25 hydroxy-vitamin D, Sclerostin (SOST) and Dickkopf-related protein 1.
Results: AN participants had higher C-terminal telopeptide of type I collagen (CTX) levels than both control groups. AN adolescents had CTX higher than AN young adults. In postmenopausal women intact N-propeptide of type I collagen was higher as compared with in each other group.
In AN groups Dickkopf-related protein 1 was significantly lower than the two control groups. No differences were found in sclerostin except in adolescents. In AN adolescents DXA BMD at femoral sites were higher than in AN young adults and it was found positively correlated with body weight (P<0,01) and with fat mass evaluated by DXA (P<0,01).
Conclusion: Our data suggest that in AN women with amenorrhoea bone resorption is as elevated as in postmenopausal women but bone formation is relatively depressed. The consequent remodelling uncoupling is considerably more severe than that occurring after menopause.
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Bone Abstracts
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