Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

被引：10
作者：
Schulze U.M.E. [1 ]
Schuler S. [2 ]
Schlamp D. [4 ]
Schneider P. [3 ]
Mehler-Wex C. [1 ]
机构：
[1] Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm
[2] Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg
[3] Clinic for Nuclear Medicine, University of Würzburg
[4] Heckscher Clinic for Child and Adolescent Psychiatry, Munich
来源：
Child and Adolescent Psychiatry and Mental Health | / 4卷 / 1期
关键词：
Bone Mineral Density; Anorexia Nervosa; Eating Disorder; Bone Mineral Content; Bulimia Nervosa;
D O I：
10.1186/1753-2000-4-20
中图分类号：
学科分类号：
摘要：
Background and aims: There still is a lack of prospective studies on bone mineral development in patients with a history of early onset Anorexia nervosa (AN). Therefore we assessed associations between bone mass accrual and clinical outcomes in a former clinical sample. In addition to an expected influence of regular physical activity and hormone replacement therapy, we explored correlations with nutritionally dependent hormones.Methods: 3-9 years (mean 5.2 ± 1.7) after hospital discharge, we re-investigated 52 female subjects with a history of early onset AN. By means of a standardized approach, we evaluated the general outcome of AN. Moreover, bone mineral content (BMC) and bone mineral density (BMD) as well as lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). In a substudy, we measured the serum concentrations of leptin and insulin-like growth factor-I (IGF-I).Results: The general outcome of anorexia nervosa was good in 50% of the subjects (BMI ≥ 17.5 kg/m2, resumption of menses). Clinical improvement was correlated with BMC and BMD accrual (χ2 = 5.62/χ2 = 6.65, p = 0.06 / p = 0.036). The duration of amenorrhea had a negative correlation with BMD (r = -.362; p < 0.01), but not with BMC. Regular physical activity tended to show a positive effect on bone recovery, but the effect of hormone replacement therapy was not significant. Using age-related standards, the post-discharge sample for the substudy presented IGF-I levels below the 5th percentile. IGF-I serum concentrations corresponded to the general outcome of AN. By contrast, leptin serum concentrations showed great variability. They correlated with BMC and current body composition parameters.Conclusions: Our results from the main study indicate a certain adaptability of bone mineral accrual which is dependent on a speedy and ongoing recovery. While leptin levels in the substudy tended to respond immediately to current nutritional status, IGF-I serum concentrations corresponded to the individual's age and general outcome of AN. © 2010 Schulze et al; licensee BioMed Central Ltd.
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