title: Physiologic regulators of bone turnover in young women with anorexia nervosa.
abstract: OBJECTIVE
  To clarify the role of physiologic regulators of bone turnover in patients with anorexia nervosa (AN).
  
  
  METHODS
  Adolescent girls with AN (n = 61) had anthropometric, nutrition, and exercise data acquired, and bone mineral density (BMD) and body composition measured by dual energy x-ray absorptiometry. Serum samples were obtained for hormones, proresorptive cytokines, and bone formation markers, and urine for bone resorption markers.
  
  
  RESULTS
  In bivariate correlation analyses, significant (P <.05) predictors of lumbar BMD included height, weight, and exercise. In multiple regression models, these significant relationships held, even after controlling for the duration of amenorrhea and AN. For total body BMD, the same positive predictors were found and percentage of body fat was a negative correlate. For hip BMD, exercise and weight were found to be positive predictors. Dehydroepiandrosterone sulfate (DHEAS) was inversely correlated with N-telopeptides (NTx), and insulin-like growth factor I (IGF-I) was directly correlated with osteocalcin. Proresorptive cytokine levels were low or undetectable.
  
  
  CONCLUSIONS
  Exercise and weight were positive predictors of BMD. These data are the first to suggest a relationship between DHEAS and increased bone resorption in AN. IGF-I was correlated with bone formation indices. Low cytokine levels suggest that these factors do not mediate the increased bone resorption of AN.
authors.affiliation: Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, Massachusetts 02115, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Goodman
authors.forename: S Jean
authors.initials: SJ
authors.lastname: Emans
authors.forename: Estherann
authors.initials: E
authors.lastname: Grace
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Becker
authors.forename: Clifford J
authors.initials: CJ
authors.lastname: Rosen
authors.forename: Caren M
authors.initials: CM
authors.lastname: Gundberg
authors.forename: Meryl S
authors.initials: MS
authors.lastname: Leboff
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications*; D015415:Biomarkers; D015519:Bone Density / Q000502:physiology*; D001862:Bone Resorption / Q000209:etiology* / Q000503:physiopathology*; D016207:Cytokines / Q000097:blood; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D015444:Exercise; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D015999:Multivariate Analysis; D010012:Osteogenesis / Q000502:physiology*; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D016207:Cytokines; D019314:Dehydroepiandrosterone Sulfate; D007334:Insulin-Like Growth Factor I