Prognostic Indicators of Changes in Bone Density Measures in Adolescent Girls with Anorexia Nervosa-II

Overview

Journal J Clin Endocrinol Metab

Publisher Oxford University Press

Specialty Endocrinology

Date 2007 Dec 20

PMID 18089697

Citations 24

Authors

Madhusmita Misra

Rajani Prabhakaran

Karen K Miller

Mark A Goldstein

Diane Mickley

Laura Clauss

Patrice Lockhart

Jennalee Cord

David B Herzog

Debra K Katzman

Anne Klibanski

Affiliations

Soon will be listed here.

Abstract

Introduction: Adolescents with anorexia nervosa (AN) have low bone mineral density (BMD). Baseline predictors of temporal BMD changes (DeltaBMD) in AN, including 1) gastrointestinal peptides regulating food intake and appetite that have been related to bone metabolism and 2) bone turnover markers, have not been well characterized. We hypothesized that baseline levels of nutritionally regulated hormones and of bone turnover markers would predict DeltaBMD overall.

Methods: In a prospective observational study, lumbar and whole-body BMD was measured at 0, 6, and 12 months in 34 AN girls aged 12-18 yr and 33 controls. Baseline body mass index, lean mass, nutritionally regulated hormones [IGF-I, cortisol, ghrelin, leptin, and peptide YY (PYY)], bone formation, and resorption markers were examined to determine nutritional and hormonal predictors of bone density changes.

Results: In a regression model, baseline ghrelin and PYY predicted changes in spine bone measures; and baseline ghrelin, cortisol, and PYY predicted changes in whole-body bone measures independent of baseline nutritional status.

Conclusions: Neuroendocrine gastrointestinal-derived peptides regulating food intake are independent predictors of changes in bone mass in AN.

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References

Misra M, Prabhakaran R, Miller K, Goldstein M, Mickley D, Clauss L . Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa-1. J Clin Endocrinol Metab. 2007; 93(4):1231-7. PMC: 2291495. DOI: 10.1210/jc.2007-1434. View

Misra M, Miller K, Kuo K, Griffin K, Stewart V, Hunter E . Secretory dynamics of leptin in adolescent girls with anorexia nervosa and healthy adolescents. Am J Physiol Endocrinol Metab. 2005; 289(3):E373-81. DOI: 10.1152/ajpendo.00041.2005. View

. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Normal reference laboratory values. N Engl J Med. 1992; 327(10):718-24. DOI: 10.1056/NEJM199209033271009. View

Weiss L, Barrett-Connor E, von Muhlen D, Clark P . Leptin predicts BMD and bone resorption in older women but not older men: the Rancho Bernardo study. J Bone Miner Res. 2006; 21(5):758-64. DOI: 10.1359/jbmr.060206. View

Bachrach L, Guido D, Katzman D, Litt I, Marcus R . Decreased bone density in adolescent girls with anorexia nervosa. Pediatrics. 1990; 86(3):440-7. View

Soyka L, Misra M, Frenchman A, Miller K, Grinspoon S, Schoenfeld D . Abnormal bone mineral accrual in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab. 2002; 87(9):4177-85. DOI: 10.1210/jc.2001-011889. View

Delhanty P, van der Eerden B, van der Velde M, Gauna C, Pols H, Jahr H . Ghrelin and unacylated ghrelin stimulate human osteoblast growth via mitogen-activated protein kinase (MAPK)/phosphoinositide 3-kinase (PI3K) pathways in the absence of GHS-R1a. J Endocrinol. 2006; 188(1):37-47. DOI: 10.1677/joe.1.06404. View

Riggs B, Khosla S, Melton 3rd L . Sex steroids and the construction and conservation of the adult skeleton. Endocr Rev. 2002; 23(3):279-302. DOI: 10.1210/edrv.23.3.0465. View

Misra M, Miller K, Stewart V, Hunter E, Kuo K, Herzog D . Ghrelin and bone metabolism in adolescent girls with anorexia nervosa and healthy adolescents. J Clin Endocrinol Metab. 2005; 90(9):5082-7. DOI: 10.1210/jc.2005-0512. View

10.

Tschop M, Smiley D, Heiman M . Ghrelin induces adiposity in rodents. Nature. 2000; 407(6806):908-13. DOI: 10.1038/35038090. View

11.

Misra M, Miller K, Bjornson J, Hackman A, Aggarwal A, Chung J . Alterations in growth hormone secretory dynamics in adolescent girls with anorexia nervosa and effects on bone metabolism. J Clin Endocrinol Metab. 2003; 88(12):5615-23. DOI: 10.1210/jc.2003-030532. View

12.

Misra M, Prabhakaran R, Miller K, Tsai P, Lin A, Lee N . Role of cortisol in menstrual recovery in adolescent girls with anorexia nervosa. Pediatr Res. 2006; 59(4 Pt 1):598-603. DOI: 10.1203/01.pdr.0000203097.64918.63. View

13.

Boyar R, HELLMAN L, ROFFWARG H, Katz J, Zumoff B, OConnor J . Cortisol secretion and metabolism in anorexia nervosa. N Engl J Med. 1977; 296(4):190-3. DOI: 10.1056/NEJM197701272960403. View

14.

Misra M, Miller K, Cord J, Prabhakaran R, Herzog D, Goldstein M . Relationships between serum adipokines, insulin levels, and bone density in girls with anorexia nervosa. J Clin Endocrinol Metab. 2007; 92(6):2046-52. DOI: 10.1210/jc.2006-2855. View

15.

Kim S, Her S, Park S, Kim D, Park K, Lee H . Ghrelin stimulates proliferation and differentiation and inhibits apoptosis in osteoblastic MC3T3-E1 cells. Bone. 2005; 37(3):359-69. DOI: 10.1016/j.bone.2005.04.020. View

16.

Di Somma C, Pivonello R, Loche S, Faggiano A, Marzullo P, Di Sarno A . Severe impairment of bone mass and turnover in Cushing's disease: comparison between childhood-onset and adulthood-onset disease. Clin Endocrinol (Oxf). 2002; 56(2):153-8. DOI: 10.1046/j.0300-0664.2001.01454.doc.x. View

17.

Maccarinelli G, Sibilia V, Torsello A, Raimondo F, Pitto M, Giustina A . Ghrelin regulates proliferation and differentiation of osteoblastic cells. J Endocrinol. 2005; 184(1):249-56. DOI: 10.1677/joe.1.05837. View

18.

Abad V, Chrousos G, Reynolds J, Nieman L, Hill S, Weinstein R . Glucocorticoid excess during adolescence leads to a major persistent deficit in bone mass and an increase in central body fat. J Bone Miner Res. 2001; 16(10):1879-85. DOI: 10.1359/jbmr.2001.16.10.1879. View

19.

Kooh S, Noriega E, Leslie K, Muller C, Harrison J . Bone mass and soft tissue composition in adolescents with anorexia nervosa. Bone. 1996; 19(2):181-8. DOI: 10.1016/8756-3282(96)00162-7. View

20.

Ducy P, Amling M, Takeda S, Priemel M, Schilling A, Beil F . Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell. 2000; 100(2):197-207. DOI: 10.1016/s0092-8674(00)81558-5. View