Follow-up of bone mineral density and body composition in adolescents with restrictive anorexia nervosa: role of dual-energy X-ray absorptiometry
Background/Objectives: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass—FM and lean mass—LM). The aim of our study was to address whether bone and...
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| Published in | European journal of clinical nutrition Vol. 68; no. 2; pp. 247 - 252 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
London
Nature Publishing Group UK
01.02.2014
Nature Publishing Group |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0954-3007 1476-5640 1476-5640 |
| DOI | 10.1038/ejcn.2013.254 |
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| Abstract | Background/Objectives:
Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass—FM and lean mass—LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR.
Subjects/Methods:
Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry—DXA at baseline-T0 and after 12 months-T12. Among the 46/79—58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and
Z
-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity.
Results:
At T0: body mass index (BMI)=16.4±1.4 kg/m
2
with low levels of FM% (21.7±5.7) low BMC in 12/46—26.0% (mean
Z
-score: −1.21±1.27, with higher values related to physical activity—
P
=0.001). At T12: a significant increase in BMI—
P
=0.001, with LM reduction and FM increase (more evident in the trunk—
P
<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses.
Conclusions:
After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. |
|---|---|
| AbstractList | Background/ Objectives: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass-FM and lean mass-LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR.Subjects/ Methods: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry-DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity. Results: At T0: body mass index (BMI)=16.4 plus or minus 1.4 kg/m super(2) with low levels of FM% (21.7 plus or minus 5.7) low BMC in 12/46-26.0% (mean Z-score: -1.21 plus or minus 1.27, with higher values related to physical activity-P=0.001). At T12: a significant increase in BMI-P=0.001, with LM reduction and FM increase (more evident in the trunk-P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses. Conclusions: After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. SUBJECTS/METHODS: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry--DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/ hormonal therapy and physical activity. European Journal of Clinical Nutrition (2014) 68, 247-252; doi: 10.1038/ejcn.2013.254; published online 18 December 2013 Background/Objectives: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass—FM and lean mass—LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR. Subjects/Methods: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry—DXA at baseline-T0 and after 12 months-T12. Among the 46/79—58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z -score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity. Results: At T0: body mass index (BMI)=16.4±1.4 kg/m 2 with low levels of FM% (21.7±5.7) low BMC in 12/46—26.0% (mean Z -score: −1.21±1.27, with higher values related to physical activity— P =0.001). At T12: a significant increase in BMI— P =0.001, with LM reduction and FM increase (more evident in the trunk— P <0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses. Conclusions: After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass-FM and lean mass-LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR. Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry-DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity. At T0: body mass index (BMI)=16.4±1.4 kg/m2 with low levels of FM% (21.7±5.7) low BMC in 12/46-26.0% (mean Z-score: -1.21±1.27, with higher values related to physical activity-P=0.001). At T12: a significant increase in BMI-P=0.001, with LM reduction and FM increase (more evident in the trunk-P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses. After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass-FM and lean mass-LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR.BACKGROUND/OBJECTIVESRestrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass-FM and lean mass-LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR.Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry-DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity.SUBJECTS/METHODSProspective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry-DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity.At T0: body mass index (BMI)=16.4±1.4 kg/m2 with low levels of FM% (21.7±5.7) low BMC in 12/46-26.0% (mean Z-score: -1.21±1.27, with higher values related to physical activity-P=0.001). At T12: a significant increase in BMI-P=0.001, with LM reduction and FM increase (more evident in the trunk-P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses.RESULTSAt T0: body mass index (BMI)=16.4±1.4 kg/m2 with low levels of FM% (21.7±5.7) low BMC in 12/46-26.0% (mean Z-score: -1.21±1.27, with higher values related to physical activity-P=0.001). At T12: a significant increase in BMI-P=0.001, with LM reduction and FM increase (more evident in the trunk-P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses.After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients.CONCLUSIONSAfter 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. BACKGROUND/OBJECTIVES: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass--FM and lean mass--LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR. SUBJECTS/METHODS: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry--DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/ hormonal therapy and physical activity. RESULTS: At T0: body mass index (BMI) = 16.4 ± 1.4 kg/[m.sup.2] with low levels of FM% (21.7 ± 5.7) low BMC in 12/46-26.0% (mean Z-score: - 1.21 ±1.27, with higher values related to physical activity--P = 0.001). At T12: a significant increase in BMI--P = 0.001, with LM reduction and FM increase (more evident in the trunk--P<0.001);regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses. CONCLUSIONS: After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. European Journal of Clinical Nutrition (2014) 68, 247-252; doi: 10.1038/ejcn.2013.254; published online 18 December 2013 Keywords: dual-energy X-Ray absorptiometry; anorexia nervosa; pathologic bone demineralization; body composition Background/Objectives: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass-FM and lean mass-LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR. Subjects/Methods: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry-DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity. Results: At T0: body mass index (BMI)=16.4±1.4kg/m(2) with low levels of FM% (21.7±5.7) low BMC in 12/46-26.0% (mean Z-score: -1.21±1.27, with higher values related to physical activity-P=0.001). At T12: a significant increase in BMI-P=0.001, with LM reduction and FM increase (more evident in the trunk-P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses. Conclusions: After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients.[PUBLICATION ABSTRACT] Background/Objectives:Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass—FM and lean mass—LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR.Subjects/Methods:Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry—DXA at baseline-T0 and after 12 months-T12. Among the 46/79—58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity.Results:At T0: body mass index (BMI)=16.4±1.4 kg/m2 with low levels of FM% (21.7±5.7) low BMC in 12/46—26.0% (mean Z-score: −1.21±1.27, with higher values related to physical activity—P=0.001). At T12: a significant increase in BMI—P=0.001, with LM reduction and FM increase (more evident in the trunk—P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses.Conclusions:After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients. |
| Audience | Professional Academic |
| Author | Battista, G Franzoni, E Iero, L Facchini, G Moscano, F Bazzocchi, A Di Pietro, E Ciccarese, F Monaldi, A |
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| Keywords | body composition pathologic bone demineralization anorexia nervosa dual-energy X-Ray absorptiometry Human Osteoarticular system Dual energy absorptiometry Adolescent Metabolic diseases Bone mineral density Anorexia nervosa Bone Eating disorder Body composition |
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| References_xml | – volume: 77 start-page: 1361 year: 2003 end-page: 1367 ident: CR24 article-title: Regional body compositions in adolescents with anorexia nervosa and changes with weight recovery publication-title: Am J Clin Nutr doi: 10.1093/ajcn/77.6.1361 – volume: 82 start-page: 123 year: 2009 end-page: 130 ident: CR16 article-title: Whole-body adipose tissue analysis: comparison of MRI, CT and dual energy X-ray absorptiometry publication-title: Br J Radiol doi: 10.1259/bjr/80083156 – year: 1991 ident: CR13 publication-title: Manual for the Child Behavior Checklist/4–18 and 1991 Profile – volume: 19 start-page: 194 year: 2011 end-page: 202 ident: CR5 article-title: Osteoporosis in anorexia nervosa publication-title: Eat Disord doi: 10.1080/10640266.2011.551636 – volume: 81 start-page: 1286 year: 2005 end-page: 1291 ident: CR22 article-title: Body fat redistribution after weight gain in women with anorexia nervosa publication-title: Am J Clin Nutr doi: 10.1093/ajcn/81.6.1286 – 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predictive factors for regional osteopenia in women with anorexia nervosa publication-title: Ann Intern Med doi: 10.7326/0003-4819-133-10-200011210-00011 – volume: 42 start-page: 195 year: 2009 end-page: 201 ident: CR3 article-title: Treatment of osteopenia and osteoporosis in anorexia nervosa: a systematic review of the literature publication-title: Int J Disord doi: 10.1002/eat.20593 – ident: CR7 – volume: 25 start-page: 298 year: 2010 end-page: 304 ident: CR4 article-title: Bone marrow changes in adolescent girls with anorexia nervosa publication-title: J Bone Miner Res doi: 10.1359/jbmr.090805 – volume: 91 start-page: 2931 year: 2006 end-page: 2937 ident: CR19 article-title: Determinants of skeletal loss and recovery in anorexia nervosa publication-title: J Clin Endocrinol Metab doi: 10.1210/jc.2005-2818 – volume: 11 start-page: 75 year: 2008 ident: BFejcn2013254_CR14 publication-title: J Clin Densitom doi: 10.1016/j.jocd.2007.12.007 – volume: 380 start-page: e1 year: 2012 ident: 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Radiol. 2009 Feb;82(974):123-30 – reference: 10793872 - Osteoporos Int. 2000;11(2):141-5 – reference: 21976742 - J Clin Endocrinol Metab. 2011 Oct;96(10):2939-49 – reference: 15941877 - Am J Clin Nutr. 2005 Jun;81(6):1286-91 – reference: 12091853 - J Pediatr. 2002 Jul;141(1):64-70 – reference: 15713709 - J Clin Endocrinol Metab. 2005 May;90(5):2580-7 – reference: 18951456 - Int J Eat Disord. 2009 Apr;42(3):195-201 – reference: 12791610 - Am J Clin Nutr. 2003 Jun;77(6):1361-7 – reference: 20840252 - Ann N Y Acad Sci. 2010 Sep;1205:45-50 – reference: 16735492 - J Clin Endocrinol Metab. 2006 Aug;91(8):2931-7 – reference: 15852310 - Int J Eat Disord. 2005;37 Suppl:S2-9; discussion S20-1 – reference: 18442754 - J Clin Densitom. 2008 Jan-Mar;11(1):75-91 – reference: 21365578 - Endokrynol Pol. 2011 Jan-Feb;62(1):45-7 – reference: 21360368 - Eat Disord. 2011 Mar-Apr;19(2):194-202 – reference: 11085841 - Ann Intern Med. 2000 Nov 21;133(10):790-4 – reference: 19653811 - J Bone Miner Res. 2010 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Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in... Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition... BACKGROUND/OBJECTIVES: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in... SUBJECTS/METHODS: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry--DXA at baseline-T0 and after 12 months-T12. Among... Background/Objectives: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in... Background/Objectives:Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in... Background/ Objectives: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in... |
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| SubjectTerms | 631/443/319/1488 692/699/2743/316 692/699/476 692/700/2814 Absorptiometry, Photon Adolescent Adolescents Amenorrhea Amenorrhea - etiology Anorexia Anorexia nervosa Anorexia Nervosa - complications Anorexia Nervosa - physiopathology Biological and medical sciences Body Composition Body fat Body Mass Index Body size Bone composition Bone Demineralization, Pathologic - etiology Bone densitometry Bone Density Bone mass Bone mineral content Bone mineral density Bones Clinical Nutrition Density Diagnosis Dual energy X-ray absorptiometry Eating disorders Epidemiology Exercise Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Humans Internal Medicine Investigative techniques, diagnostic techniques (general aspects) Medical sciences Medicine Medicine & Public Health Menarche Metabolic Diseases Methods original-article Osteoarticular system. Muscles Patients Physical activity Physiological aspects Prospective Studies Public Health Radiodiagnosis. Nmr imagery. Nmr spectrometry Risk analysis Risk factors Teenagers Vertebrates: anatomy and physiology, studies on body, several organs or systems X-rays Young Adult |
| Title | Follow-up of bone mineral density and body composition in adolescents with restrictive anorexia nervosa: role of dual-energy X-ray absorptiometry |
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