Low trabecular bone score in adolescent female inpatients with anorexia nervosa

Levy‐Shraga, Yael; Tripto-Shkolnik, Liana; David, Dana; Vered, Iris; Stein, Dan J.; Modan‐Moses, Dalit

doi:10.1016/j.clnu.2018.04.013

Cited by 14 publications

(12 citation statements)

References 19 publications

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“…Most studies found significant correlations between TBS and aBMD ( R = 0.18 to 0.49 in boys, R = 0.32 to 0.81 in girls), ( 28,29,31,33,34 ) and between TBS and aBMD Z ‐scores ( R = 0.44–0.65 in girls, no data for boys). ( 29,31,32 ) The relationship between TBS and height or BMI were reported as not significant by some authors, whereas other studies found correlations. ( 28,29,31–34 )…”

Section: Discussionmentioning

confidence: 96%

“…( 29,31,32 ) The relationship between TBS and height or BMI were reported as not significant by some authors, whereas other studies found correlations. ( 28,29,31–34 )…”

Section: Discussionmentioning

confidence: 96%

“…To date, only few studies have analyzed the assessment of TBS in children and adolescents ( 27–33 ) and no pediatric reference data of larger cohorts have been published. New data were presented during international conferences, including mean TBS values for age in a study population of 4127 healthy, typically developing children and adolescents.…”

Section: Introductionmentioning

confidence: 99%

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Bone Microarchitecture Assessed by Trabecular Bone Score Is Independent of Mobility Level or Height in Pediatric Patients with Cerebral Palsy

Rehberg

Azim

Martakis

et al. 2020

Journal of Bone and Mineral Research

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Bone strength and fracture risk do not only depend on bone density, but also on bone structure. The trabecular bone score (TBS) evaluates homogeneity of bone microarchitecture indirectly by measuring gray‐level variations of two‐dimensional (2D) DXA images. Although TBS is well‐established for adults, there have been only few publications in pediatrics. In this monocentric retrospective analysis, we investigated TBS in children and adolescents with cerebral palsy (CP), a patient group vulnerable to low bone mineral mass due to impaired mobility. The influence of different parameters on TBS and areal BMD (aBMD) were evaluated, as well as the relationship between TBS and aBMD. We compared TBS values of our study population to a reference population. A total of 472 lumbar spine–dual‐energy X‐ray absorptiometry (LS‐DXA) scans of children and adolescents with CP (205 female), aged between 4 and 18 years, were analyzed. The DXA‐scans were part of the routine examination. The children had no records of fractures or specific bone diseases. Our study population with CP had similar TBS as the reference population. TBS did not increase with age until an inflection point at 10 years in females, and 12 years in males. Girls had significantly higher TBS than boys (p = .049) and pubertal girls aged 8 to 13 years had significantly higher TBS than prepubertal girls (p = .009). TBS standard deviation score for age (SDS‐TBS) and aBMD Z‐scores correlated weakly (p < .001; R = 0.276 [males], R = 0.284 [females]). Other than for aBMD Z‐scores, SDS‐TBS was not influenced by age‐adjusted height Z‐scores and there was no significant difference in SDS‐TBS when grouped by mobility levels, using the Gross Motor Function Classification System (GMFCS). Our results indicate that children with CP have a similar homogeneous distribution of trabecular microarchitecture as controls. Puberty initiation appears to be essential for increase of TBS with age and for sex differences. TBS seems less influenced by body composition, height, and mobility than aBMD. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.

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Section: Discussionmentioning

confidence: 96%

“…( 29,31,32 ) The relationship between TBS and height or BMI were reported as not significant by some authors, whereas other studies found correlations. ( 28,29,31–34 )…”

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Bone Microarchitecture Assessed by Trabecular Bone Score Is Independent of Mobility Level or Height in Pediatric Patients with Cerebral Palsy

Rehberg

Azim

Martakis

et al. 2020

Journal of Bone and Mineral Research

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“…On average, participants were older and more severe compared with previous studies on this subject. 8,[24][25][26] The prevalence of low BMD at lumbar spine was 51% with an average Z-score of −2.2 SD. Pre-existing research reports lower prevalence rates, ranging from 21% to 40% depending on population age and diagnostic criteria (T-scores vs Z-scores).…”

Section: Discussionmentioning

confidence: 99%

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

Bemer

Lodovico

Haykanush

et al. 2021

Clinical Endocrinology

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Anorexia nervosa (AN) is a severe eating disorder characterized by an emotional and cognitive inability to maintain a normal weight.Quantitative and qualitative restriction of nutritional intakes, purging behaviours, physical hyperactivity and laxative abuse are the main strategies to control weight and shape. These behaviours are maintained by a persisting distortion of body image, generating a vicious circle of weight loss. 1 Prevalence varies between 0.9% and 4% among women and is 10 to 13 times lower among men. [2][3][4] Weight control strategies progressively lead to malnutrition, which in turn can generate acute and chronic somatic complications, functional damage and decreased quality of life. 5 Bone mineral density (BMD) loss is a potentially irreversible consequence of AN,6,7 favoured by the combined effect on malnutrition, vitamin D deficiency, hypoestrogenism, elevated serum cortisol and low body mass index (BMI). 7,8 Epidemiological studies indicate that 45 to 95% of patients with AN suffer from osteopenia and up to 40% suffer from osteoporosis. 9-11 Bone fragility exposes these patients to a sevenfold increased risk of fractures, compared to healthy individuals of

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“…This study is the first to evaluate the additional utility of TBS in adult premenopausal patients with severe AN. While TBS is a fairly novel tool to assess bone health, there have been two recent TBS‐based studies in adolescent patients with mild–moderate AN (Donaldson, Feldman, O'Donnell, Gopalakrishnan, & Gordon, 2015; Levy‐Shraga et al, 2019). There is also, a just published, small TBS study in adults with mild AN (Wanby, Brudin, Von, & Carlsson, 2020).…”

Section: Discussionmentioning

confidence: 99%

Bone quality assessed by trabecular bone score in severe anorexia nervosa: A brief report

Watters

Fielding

Mehler

2021

Intl J Eating Disorders

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Objective Low bone mineral density (BMD) in anorexia nervosa (AN) leads to increased risk of fractures. Debate exists whether to medicinally treat young patients with AN based on abnormal dual‐energy x‐ray absorptiometry (DXA) scores or to weight restore and reassess when older. Trabecular bone score (TBS), a technology measuring bone quality, is used in conjunction with DXA. This report explores the potential additional value of TBS, in adults with severe AN, to augment the DXA diagnostic information. Method Seventy‐one DXA scans were reanalyzed to obtain TBS results from patients (mean age: 36.3 years). Differences in laboratory, anthropometric values and concomitant DXA measurements in relation to TBS results are reported. Results For the cohort, mean body mass index (BMI) was 13.6 kg/m2 (SD: 2.1). The vast majority of patients had normal TBS with a mean of 1.395 (SD: 0.08) but, most patients (69%) had abnormal average DXA BMD Z‐scores of −2.2 (SD: 1.2). The patients who also demonstrated degraded bone quality on TBS had significantly lower percent ideal body weight and elevated alkaline phosphatase compared to patients with normal TBS (p's < .05). Discussion Low BMD treatment decisions in AN may be optimized by considering both DXA and TBS results.

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Low trabecular bone score in adolescent female inpatients with anorexia nervosa

Cited by 14 publications

References 19 publications

Bone Microarchitecture Assessed by Trabecular Bone Score Is Independent of Mobility Level or Height in Pediatric Patients with Cerebral Palsy

Bone Microarchitecture Assessed by Trabecular Bone Score Is Independent of Mobility Level or Height in Pediatric Patients with Cerebral Palsy

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

Bone quality assessed by trabecular bone score in severe anorexia nervosa: A brief report

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