Bone Abstracts

Introduction: Anorexia nervosa usually has its onset during adolescence, the critical time when peak bone mass is accrued. Inadequate nutrition abnormalities and endocrine changes during starvation have a negative effect on bone health. The aim of this work was to investigate the effects of hormonal and auxological parameters on markers of bone metabolism, bone mineral density in girls with anorexia.

Patients and methods: In groups of 45 girls with anorexia nervosa (x=16.15±2.67 years) at different stages of the disease, we examined deficit of weight, disease duration, duration of amenorrhea and laboratory parameters of bone metabolism (vitamin D, osteocalcin CTx, estradiol, IGF1). Dual X-ray absorptiometry (DXA) was used to assess the bone mineral density (BMD). The results were evaluated as DXA Z-scores for the age - matched controls and sex pubertal development.

Results: BMD Z-score – lumbal spine (LS) was −0.8±1.27, proximal femur −1.1±1.22. 11 patients (24%) had bone density less than −2 S.D. for the age. Anorectic girls with reduced density had a longer duration of disease (22 months versus 12.85 months), significantly lower vitamin D (vs 19.48, 27.50 ng/ml, P ≤ 0.05), estradiol (19.48 vs 27.50 pg/ml, P ≤ 0.05) and IGF1 (174.11 vs 261.89 ng/ml) as anorectic girls with normal BMD. Low BMD was associated with lower concentrations of osteocalcin CTx. BMD of proximal femur correlated with estradiol (r=0.48). An inverse relationship between vitamin D and PTH (r=−0.55) points (proves) to maintaining control of calcium metabolism even during the critical weight loss.

Conclusion: Severe nutritional deficiency and adaptive hormonal changes in anorexia nervosa could lead to a reduction of bone mass as well as to increase fracture risk later in life.

Disclosure: The authors declared no competing interests.