The effects of bone therapy on tibial bone loss in young women with anorexia nervosa

Nakahara, Toshihiro; Nagai, Nobuatsu; Tanaka, Muneki; Muranaga, Tetsuro; Kojima, Shinya; Nozoe, Shigeo; Naruo, Tetsuro

doi:10.1002/eat.20197

Cited by 25 publications

(12 citation statements)

References 46 publications

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“…A second small randomized placebo controlled trial of daily etidronate versus daily calcium and vitamin D versus placebo for only 3 months showed a significant improvement in tibial speed-of-sound as the measure of BMD. 40 Given the unclear method of randomization, short duration of follow-up, unusual outcome measure, multiple comparisons, and unlikely benefit of short course calcium and vitamin D, we strongly question the validity of these findings. Currently, bisphosphonates should not be routinely used in patients with AN of child-bearing age until further research defines their long-term safety and efficacy; there may, however, be a future role for their usage.…”

Section: Bisphosphonatesmentioning

confidence: 92%

Treatment of osteopenia and osteoporosis in anorexia nervosa: A systematic review of the literature

Mehler

MacKenzie

2008

Intl J Eating Disorders

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Section: Bisphosphonatesmentioning

confidence: 92%

Treatment of osteopenia and osteoporosis in anorexia nervosa: A systematic review of the literature

Mehler

MacKenzie

2008

Intl J Eating Disorders

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“…Approximately 30% of adolescent girls, as well as adult women with AN, report sustaining a fracture [6, 8]. Of note, both subtypes of AN, the restricting sub-type (AN-R) and the binge-purge subtype (AN-BP), are associated with reductions in spine BMD and increased fracture risk compared to controls [9]. AN-R and AN-BP are also associated with lower total body, hip and limb BMD, even in population-based samples, as shown in a longitudinal study from the UK [10*].…”

Section: Introductionmentioning

confidence: 99%

Eating disorders and bone metabolism in women

Robinson

Micali

Misra

2017

Current Opinion in Pediatrics

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Purpose of this Review Eating Disorders are psychiatric disorders associated with high risk for low bone mineral density (BMD) and fractures. Low BMD is likely to be a consequence of undernutrition, changes in body composition, and hormonal alterations. This review summarizes recent findings regarding: novel strategies for assessing bone outcomes in patients with eating disorders, factors contributing to altered bone metabolism, and possible therapeutic strategies. Recent Findings Emerging research in this field suggests that not only anorexia nervosa (AN), but also bulimia nervosa (BN) results in lower BMD compared to controls. To date studies of bone structure, and all randomized controlled trials (RCTs) examining the impact of various therapies on bone outcomes in AN, have focused on adolescent girls and women. We discuss the impact of AN on bone structure, and associations of resting energy expenditure, marrow adipose tissue (including the ratio of saturated to unsaturated fat), and cold activated brown adipose tissue (BAT) with BMD and bone structure. Promising strategies for treatment include physiological estrogen replacement (rather than oral contraceptives), in adolescent girls with AN, and bisphosphonates, as well as teriparatide, in adult women with AN. Summary Recent data on: (i) BMD and bone structure in adolescent girls and women with eating disorders, (ii) factors that contribute to altered bone metabolism, and (iii) RCTs reporting positive effects of physiologic estrogen replacement, bisphosphonates and teriparatide on bone health provide us with a greater understanding of the impact of eating disorders on bone and novel management strategies.

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“…Adolescents with AN are also at risk for low BMD, with approximately 30% of adolescent girls reporting sustaining a fracture [5,7] and 50% reported to have BMD 1 SD below the mean at one or more skeletal sites [6]. Both restricting sub-type (AN-R) and the binge-purge subtype (AN-BP) of AN are associated with reductions in spine, hip and limb BMD [11] and increased fracture risk [12]. A recent meta-analysis found normal weight women with BN to have spinal BMD significantly lower than healthy control women [13], suggesting that weight loss alone may not account for the deleterious effects of an ED on BMD.…”

Section: Eating Disordersmentioning

confidence: 99%

Pharmacological treatment options for low Bone Mineral Density and secondary osteoporosis in Anorexia Nervosa: A systematic review of the literature

Robinson

Aldridge

Clark

et al. 2017

Journal of Psychosomatic Research

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms Results: 675 studies were reviewed, of which 19 fit the inclusion criteria and were included in the final review, investigating a total of 1119 participants; 10 of the 19 included studies were double-blind RCTs.The remaining studies consisted of prospective observational studies, a retrospective cohort study, a case-control study and five non-randomised control trials. Bisphosphonates were effective in increasing BMD in adult women with AN, while estrogen administered transdermally resulted in significant increases in BMD in mature adolescents with AN. Administration of Oral contraceptives (OC) did not significantly increase BMD in randomised or controlled trials, however, lifetime OC use was associated with higher spinal BMD.Conclusion: Future research should clarify the safety of long-term bisphosphonate use in adult women with AN, and verify that transdermal estrogen replacement increases BMD in women with AN.

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The effects of bone therapy on tibial bone loss in young women with anorexia nervosa

Cited by 25 publications

References 46 publications

Treatment of osteopenia and osteoporosis in anorexia nervosa: A systematic review of the literature

Treatment of osteopenia and osteoporosis in anorexia nervosa: A systematic review of the literature

Eating disorders and bone metabolism in women

Pharmacological treatment options for low Bone Mineral Density and secondary osteoporosis in Anorexia Nervosa: A systematic review of the literature

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