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- Title
Bone metabolism in adolescent boys with anorexia nervosa.
- Authors
Misra, Madhusmita; Katzman, Debra K; Cord, Jennalee; Manning, Stephanie J; Mendes, Nara; Herzog, David B; Miller, Karen K; Klibanski, Anne
- Abstract
<bold>Background: </bold>Anorexia nervosa (AN) is a condition of severe undernutrition associated with low bone mineral density (BMD) in adolescent females with this disorder. Although primarily a disease in females, AN is increasingly being recognized in males. However, there are few or no data regarding BMD, bone turnover markers or their predictors in adolescent AN boys.<bold>Hypotheses: </bold>We hypothesized that BMD would be low in adolescent boys with AN compared with controls associated with a decrease in bone turnover markers, and that the gonadal steroids, testosterone and estradiol, and levels of IGF-I and the appetite regulatory hormones leptin, ghrelin, and peptide YY would predict BMD and bone turnover markers.<bold>Methods: </bold>We assessed BMD using dual-energy x-ray absorptiometry and measured fasting testosterone, estradiol, IGF-I, leptin, ghrelin, and peptide YY and a bone formation (aminoterminal propeptide of type 1 procollagen) and bone resorption (N-telopeptide of type 1 collagen) marker in 17 AN boys and 17 controls 12-19 yr old.<bold>Results: </bold>Boys with AN had lower BMD and corresponding Z-scores at the spine, hip, femoral neck, trochanter, intertrochanteric region, and whole body, compared with controls. Height-adjusted measures (lumbar bone mineral apparent density and whole body bone mineral content/height) were also lower. Bone formation and resorption markers were reduced in AN, indicating decreased bone turnover. Testosterone and lean mass predicted BMD. IGF-I was an important predictor of bone turnover markers.<bold>Conclusion: </bold>AN boys have low BMD at multiple sites associated with decreased bone turnover markers at a time when bone mass accrual is critical for attainment of peak bone mass.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2008, Vol 93, Issue 8, p3029
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2008-0170