Body mass index and disease duration are predictors of disturbed bone turnover in anorexia nervosa. A case–control study

Abstract

Objective: To characterize the influence of body mass index (BMI), body composition, hormonal factors and disease duration on bone metabolism markers in anorexia nervosa (AN) patients. Design: Case-control study with 51 AN patients and 51 controls matched for age, sex and body height. Assessment of anthropometric and bioimpedance data, and of biochemical serum parameters and of oral contraceptives use. Results: Patients had a lower BMI, lower fat mass, lower fat-free mass and lower muscle mass (MM) compared to the controls (all P values o0.001). Moreover, serum levels of osteocalcin (bone formation marker) were lower while serum C-telopeptide concentrations (CTx; bone resorption marker) and the CTx/osteocalcin ratio (an index reflecting the balance of bone remodeling) were higher in the AN patients compared to the controls (Po0.01-0.001). In addition, patients had enhanced serum calcium and cortisol levels and reduced serum levels of thyroid hormones, insulin, and leptin (P values o0.05-0.001). Mean disease duration was 91713 months. In a multiple regression analysis, BMI (Po0.0001), MM (Po0.005) and duration of the disease (Po0.005) were independent predictors of the CTx/osteocalcin ratio in the AN patients. There was a nonlinear association between BMI and the CTx/osteocalcin ratio of r ¼ À0.72 (Po0.001) in the AN patients, but only a weak relation of r ¼ À0.27 (Po0.05) between these parameters in the control subjects. Use of oral contraceptives had no effect on the CTx/ osteocalcin ratio, neither in AN patients nor in controls. Conclusions: Data indicate an uncoupling of bone formation and bone resorption in AN, which is primarily the result of a low BMI and influenced by the duration of the disease.

Body composition in adolescent idiopathic scoliosis

“…This relationship has also been described in AIS [5,[27][28][29][30]. Studies of AN demonstrate that BMI and disease duration is a strong predictor of an alteration in bone turnover.…”

“…Studies of AN demonstrate that BMI and disease duration is a strong predictor of an alteration in bone turnover. Bone turnover has been shown to be markedly disturbed when the BMI falls below 15 kg/m 2 [5,[27][28][29]. Values of BMI in AIS could be also a predictor of osteoporosis.…”

Different changes of body-images in patients with anorexia or bulimia nervosa during inpatient psychosomatic treatment

“…The practicability of bio-impedance for defining percentage of body fat Different Changes of Body-Images 89 of patients with an eating disorder has been shown in previous studies (Boschi et al, 2003;Scalfi, Marra, Caldara, Silvestri, & Contaldo, 1999;Schmidt & Klein, 1997;Weinbrenner, Zittermann, Gouni-Berthold, Stehle, & Berthold, 2003).…”

“…Analysis of bioimpedance (BIA) has been shown to be valid for the assessment of body composition also for patients with anorexia (Boschi et al, 2003;Scalfi, Marra, Caldara, Silvestri, & Contaldo, 1999;Schmidt & Klein, 1997;Weinbrenner et al, 2003). But, with severely underweight patients assessment of body composition through bioimpedance analysis or through anthropometry becomes more difficult independent of the method used (Piccoli, Codognotto, Pascoli, Boffo, & Caregaro, 2005).…”

Ocena związku między omentyną-1 a markerami metabolizmu kostnego i cytokinami systemu RANKL/RANK/OPG u dziewcząt z jadłowstrętem psychicznym

“…To our knowledge, neither the relationship between serum omentin-1 and OPG and/or RANKL levels nor the relationship between omentin-1 and OC/CTx and/or OPG/sRANKL ratios have been assessed in girls with AN. The OC/CTx or CTx/OC ratios have been widely used as indices of bone remodelling balance [21,22]. The relative OPG/RANKL balance is important in maintaining an appropriate balance of bone remodelling [9,10,[23][24][25][26][27][28][29].…”