Recovery from osteopenia in adolescent girls with anorexia nervosa.
ABSTRACT Osteopenia is a frequent complication of anorexia nervosa (AN). To determine whether the deficit in bone mineral changes during the course of this illness, we studied 15 adolescent patients prospectively for 12-16 months using dual photon absorptiometry of the spine and whole body. At follow-up, mean weight, height, and body mass index (BMI) had increased significantly, although 6 girls had further weight loss or minimal gain (less than 1.2 kg). Spontaneous menses occurred in 2 girls, and 3 others were given estrogen replacement. Bone mineral density of the lumbar spine did not change significantly (mean +/- SD, 0.836 +/- 0.137 vs. 0.855 +/- 0.096 g/cm2), while whole body bone mineral density increased (0.710 +/- 0.118 vs. 0.773 +/- 0.105; P less than 0.05). Despite gains in bone mineral, 8 patients had osteopenia of the spine and/or whole body. Changes in weight, height, and BMI were significant predictors of change in bone mineral density. Increased bone mass occurred with weight gain before return of menses; conversely, weight loss was associated with further decreases in bone density. In 1 patient who failed to gain weight, estrogen therapy resulted in increased spinal, but not whole body, bone mineral. We also studied a second group of 9 women who had recovered from AN during adolescence. All 9 had normal whole body bone mineral for age, but 3 had osteopenia of the lumbar spine. We conclude that osteopenia in adolescents with AN reflects bone loss, perhaps combined with decreased bone accretion. Weight rehabilitation results in increased bone mineral before the return of menses. Estrogen may have an independent effect on bone mass. The persistence of osteopenia after recovery indicates that deficits in bone mineral acquired during adolescence may not be completely reversible.
SourceAvailable from: Marta Mesias01/2013;
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ABSTRACT: Type 2 diabetes (T2D) incidence in adolescents is rising, and may interfere with peak bone mass acquisition. We tested the effects of early onset T2D on bone mass, microarchitecture and strength in the TALLYHO/JngJ mouse, which develops T2D by 8 wks of age. We assessed metabolism and skeletal acquisition in male TALLYHO/JngJ and SWR/J controls (N=8-10/group) from 4 wks to 8 and 17 wks of age. Tallyho mice were obese; had ∼2-fold higher leptin and %body fat; and had lower BMD vs. SWR at all time points (p<0.03 for all). Tallyho had severe deficits in distal femur trabecular (Tb) bone volume fraction (BV/TV) (-54%), Tb number (-27%), and connectivity density (Conn.D) (-82%) (p<0.01 for all). Bone formation was higher in Tallyho mice at 8 wks but lower by 17 wks of age vs. SWR despite similar numbers of osteoblasts. Bone marrow adiposity was 7- to 50-fold higher in Tallyho vs. SWR. In vitro, primary bone marrow stromal cell differentiation into osteoblast and adipocyte lineages was similar in SWR and Tallyho, suggesting skeletal deficits were not due to intrinsic defects in Tallyho bone-forming cells. These data suggest the Tallyho mouse might be a useful model to study the skeletal effects of adolescent T2D.Endocrinology 07/2014; 155(10):en20141041. DOI:10.1210/en.2014-1041 · 4.64 Impact Factor
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ABSTRACT: A tríade da atleta é uma síndrome que ocorre em adolescentes e mulheres fisicamente ativas. Os seus componentes inter-relacionados são distúrbios alimentares, amenorréia e osteoporose. A pressão à qual adolescentes e mulheres jovens são submetidas para atingir ou manter um peso corporal irrealmente baixo está por trás dessa síndrome. Possuem maior risco as adolescentes e mulheres que praticam esportes nos quais um baixo peso corporal é importante para o desempenho ou por razões estéticas. As jovens e mulheres com um dos componentes dessa tríade devem ser investigadas para os outros.Revista Brasileira de Medicina do Esporte 08/1999; 5(4):150-158. DOI:10.1590/S1517-86921999000400007 · 0.16 Impact Factor