Weight Gain and Restoration of Menses as Predictors of Bone Mineral Density Change in Adolescent Girls with Anorexia Nervosa-1
Open Access
- 1 April 2008
- journal article
- other
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 93 (4), 1231-1237
- https://doi.org/10.1210/jc.2007-1434
Abstract
Context: Adolescents with anorexia nervosa (AN) have low bone mineral density. However, the effect of disease recovery, first, on bone density measures assessed using the Molgaard approach, which differentiates between reported low bone density resulting from short bones (based on height Z-scores) and that resulting from thin bones [based on measures of bone area (BA) for height] or light bones [based on measures of bone mineral content (BMC) for BA]; and second, on height-adjusted bone density measures, has not been well characterized. We hypothesized that menstrual recovery and weight gain (≥10% increase in body mass index) would predict an increase in these measures of bone density. Methods: In a prospective observational study, lumbar and whole-body (WB) bone density was measured at 0, 6, and 12 months in 34 AN girls aged 12–18 yr and 33 controls. Using Ward’s modification of the Molgaard approach, we determined measures of BMC for BA and BA for height at the lumbar spine and WB and also determined spine bone mineral apparent density and WB BMC adjusted for height. Results: Girls with AN had lower spine BMC for BA Z-scores (P = 0.0009), and lower WB BA for height Z (P < 0.0001), compared with controls. Menstrual recovery and weight gain in AN (AN-recovered) (median 9 months) resulted in a stabilization of BMD measures, whereas BMD continued to decrease in AN who did not gain weight and recover menses (AN-not recovered). AN-recovered also predicted greater increases in spine BMC for BA and WB BA for height, compared with AN-not recovered (P < 0.05). Conclusions: Even short-term weight gain with menstrual recovery is associated with a stabilization of BMD measures.Keywords
This publication has 29 references indexed in Scilit:
- UK reference data for the Hologic QDR Discovery dual-energy x ray absorptiometry scanner in healthy children and young adults aged 6-17 yearsArchives of Disease in Childhood, 2007
- Interpretation of whole body dual energy X-ray absorptiometry measures in children: comparison with peripheral quantitative computed tomographyBone, 2004
- Importance of lean mass in the interpretation of total body densitometry in children and adolescentsThe Journal of Pediatrics, 2003
- Regional body composition in adolescents with anorexia nervosa and changes with weight recoveryThe American Journal of Clinical Nutrition, 2003
- Abnormal Bone Mineral Accrual in Adolescent Girls with Anorexia NervosaJournal of Clinical Endocrinology & Metabolism, 2002
- Clinical and Biochemical Determinants of Bone Metabolism and Bone Mass in Adolescent Female Patients with Anorexia NervosaPediatric Research, 2002
- Adolescent Anorexia Nervosa: The Catch-up Effect in Bone Mineral Density After RecoveryJournal of the American Academy of Child & Adolescent Psychiatry, 2001
- Predictors of low bone density in young adolescent females with anorexia nervosa and other dieting disordersInternational Journal of Eating Disorders, 2001
- Energy Restriction Reduces Bone Density and Biomechanical Properties in Aged Female RatsJournal of Nutrition, 2001
- The Effects of Anorexia Nervosa on Bone Metabolism in Female Adolescents1Journal of Clinical Endocrinology & Metabolism, 1999