Bone mineral density at extremely low weight in patients with anorexia nervosa

Bemer, P.; Lodovico, Laura Di; Haykanush, Ohanyan; Théodon, Hélène; Briot, Karine; Carlier, Robert; Dicembre, M.; Duquesnoy, M.; Melchior, Jean‐Claude; Hanachi, Mouna

doi:10.1111/cen.14498

Cited by 3 publications

(4 citation statements)

References 34 publications

(54 reference statements)

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“…Similar to duration of illness, participants included in groups indicated as manifesting a severe and enduring phenotype in case studies, clinical trials and studies, tended to have substantially lower BMIs than required per the inclusion criteria. For example, participants in the Bemer et al bone mineral density (BMD) study had a mean BMI of 12.60 ± 1.60 kg/m 2 , which was well below the < 16 kg/m 2 criteria [ 62 ].…”

Section: Resultsmentioning

confidence: 99%

“… Of SE-AN group:15.95 (1.27) Defined for SE-AN Group ≥ 7 Patients in the SE-AN group had been hospitalized more often than those in the early-stage group Defined for SE-AN group: Severity of psychological distress (DASS-total ≥ 60) 2. [ 62 ] Bemer et al, 2021 Retrospective study-BMD in “extremely malnourished” “extremely severe” female inpatients with AN Bone mineral density at extremely low weight in patients with anorexia nervosa Excluded if BMI ≥ 16 Of participants: 12.60 ± 1.60 Of participants:11.10 ± 10.40 Not reported Assessed BMD but did not use this to define severity of AN. 3.…”

Section: Methodsmentioning

confidence: 99%

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Inclusion of the severe and enduring anorexia nervosa phenotype in genetics research: a scoping review

Ramsay,

Allison,

Temples

et al. 2024

J Eat Disord

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Background Anorexia nervosa has one of the highest mortality rates of all mental illnesses. For those who survive, less than 70% fully recover, with many going on to develop a more severe and enduring phenotype. Research now suggests that genetics plays a role in the development and persistence of anorexia nervosa. Inclusion of participants with more severe and enduring illness in genetics studies of anorexia nervosa is critical. Objective The primary goal of this review was to assess the inclusion of participants meeting the criteria for the severe enduring anorexia nervosa phenotype in genetics research by (1) identifying the most widely used defining criteria for severe enduring anorexia nervosa and (2) performing a review of the genetics literature to assess the inclusion of participants meeting the identified criteria. Methods Searches of the genetics literature from 2012 to 2023 were performed in the PubMed, PsycINFO, and Web of Science databases. Publications were selected per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The criteria used to define the severe and enduring anorexia nervosa phenotype were derived by how often they were used in the literature since 2017. The publications identified through the literature search were then assessed for inclusion of participants meeting these criteria. Results most prevalent criteria used to define severe enduring anorexia nervosa in the literature were an illness duration of ≥ 7 years, lack of positive response to at least two previous evidence-based treatments, a body mass index meeting the Diagnostic and Statistical Manual of Mental Disorders-5 for extreme anorexia nervosa, and an assessment of psychological and/or behavioral severity indicating a significant impact on quality of life. There was a lack of consistent identification and inclusion of those meeting the criteria for severe enduring anorexia nervosa in the genetics literature. Discussion This lack of consistent identification and inclusion of patients with severe enduring anorexia nervosa in genetics research has the potential to hamper the isolation of risk loci and the development of new, more effective treatment options for patients with anorexia nervosa.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Inclusion of the severe and enduring anorexia nervosa phenotype in genetics research: a scoping review

Ramsay,

Allison,

Temples

et al. 2024

J Eat Disord

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“…This suggests that, after removing some confounding conditions, the SIRT1/sclerostin interplay remained crucial for bone homeostasis. Although BMD is still considered a major determinant of bone strength, fragility fractures are reported only from a limited percentage of patients affected by anorexia and low BMD [ 77 ]. This evidence, together with the fact that most individuals with a fragility fracture show BMD value in the osteopenic or even in the normal range [ 60 ], indicates that other factors participate in determining bone strength and fracture risk beyond BMD and TBS.…”

Section: Discussionmentioning

confidence: 99%

Circulating SIRT1 and Sclerostin Correlates with Bone Status in Young Women with Different Degrees of Adiposity

et al. 2022

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Sirtuin1 (SIRT1) and sclerostin play important roles in adipose tissue and bone metabolism. We evaluated the circulating SIRT1 and sclerostin relationship with mass and quality of bone while considering the degree of adiposity. Sixty-six premenopausal women (16 underweight, 25 normal weight and 25 with obesity), aged <50 years, were enrolled. Plasma SIRT1, sclerostin and DXA body composition (total fat mass (FM), abdominal visceral adipose tissue, lean mass, trabecular bone score (TBS) and lumbar spine and femoral neck (FN) bone mineral density (BMD)) were assessed. The patients with obesity showed the lowest SIRT1 and TBS values and the highest sclerostin concentrations; BMD increased with FM and BMI and had an inverse association with SIRT1. Sclerostin was negatively correlated with SIRT1 (ρ = −0.37, p = 0.002). When spine BMD, FN BMD and TBS were standardized for BMI, a positive correlation with SIRT1 and a negative correlation with sclerostin were seen (p < 0.005). In the regression analysis, sclerostin was the best independent, negative predictor for BMD and TBS, while SIRT1 directly predicted TBS (p < 0.05). In conclusion, blood measurement of SIRT1 and sclerostin could represent a snapshot of the bone status that, taking into account the degree of adiposity, may reduce the interference of confounding factors in the interpretation of bone health parameters.

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“…Secondary somatic complications to undernutrition, severe weight loss and low levels of micronutrients, in addition to heart problems (bradycardia) [ 17 ], hormonal problems (amenorrhea), intestinal problems or bone demineralisation, have also been studied [ 18 , 19 ]. Nevertheless, the loss of autonomy and reduction in muscle strength are not sufficiently described in the scientific literature [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Physical Therapy Interventions in Patients with Anorexia Nervosa: A Systematic Review

Minano-Garrido

Catalán-Matamoros

Gómez-Conesa

2022

IJERPH

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Objective: Assess the effectiveness of physical therapy, including supervised physical exercise for body mass index (BMI) restoration; improving muscle strength and the psychological, behavioural, cognitive symptoms and quality of life in patients with anorexia nervosa (AN). Methods: A Systematic Review (SR) was conducted in the following scientific databases: Medline, PubMed, PEDro, PsychInfo, Cochrane Library plus, Nursing and Allied Health database, Scopus and Web of Science databases, from inception until November 2021. An assessment of the risk of bias and the certainty of evidence across studies was conducted. Articles were eligible if they followed randomized and non-randomized control trial designs with treatments based on physical therapy or exercise or physical activity in AN patients. Results: 496 records were screened, and after eligibility assessment, 6 studies from 8 articles were finally analysed. The studies, involving 176 AN patient (85.02% of patients), reported improvements in muscle strength, eating behaviour, eating attitude, mood and quality of life. Three studies included nutritional co-interventions and four studies included psychological therapy. None of the studies reported adverse effects. Conclusions: In two of the RCTs included in this SR, strength training and high intensity resistance improved the muscle strength of patients with AN. In addition, in two RCTs, improvements were observed in patients’ attitudes towards their bodies after basic body awareness therapy or after full body massage and instruction to relax. In addition, quality of life improved in two studies, with stretching, isometrics, endurance cardiovascular and muscular exercising.

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Bone mineral density at extremely low weight in patients with anorexia nervosa

Cited by 3 publications

References 34 publications

Inclusion of the severe and enduring anorexia nervosa phenotype in genetics research: a scoping review

Inclusion of the severe and enduring anorexia nervosa phenotype in genetics research: a scoping review

Circulating SIRT1 and Sclerostin Correlates with Bone Status in Young Women with Different Degrees of Adiposity

Physical Therapy Interventions in Patients with Anorexia Nervosa: A Systematic Review

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