Depression in anorexia nervosa: a risk factor for osteoporosis.
BACKGROUND
Both anorexia nervosa (AN) and depression are associated with osteoporosis. We hypothesized that adolescent girls with AN and depression will have lower bone mineral density (BMD) than anorexic girls without depression.


OBJECTIVE
The objective of this study was to investigate whether depression is an independent risk factor for osteoporosis in anorexic adolescent girls.


METHODS
This study was cross-sectional.


METHODS
This study was conducted at the University Children's Hospital (Bialystok, Poland) from October 2002 through September 2003.


METHODS
Forty-five Caucasian anorexic girls aged 13-23 yr, matched by age, Tanner stage, weight, height, calcium intake, and duration of AN, were studied, including 14 with comorbid depression (based on Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale) and 31 anorexic girls without depression.


METHODS
Total body and lumbar spine (LS) BMD, fat mass, and lean mass assessed using dual-energy x-ray absorptiometry were compared between AN girls with and without depression.


RESULTS
BMD was reduced in both groups, relative to reference data, but girls with AN and depression had lower BMD than those with AN alone (LS Z-scores, -2.6 +/- 0.3 vs. -1.7 +/- 0.3; P = 0.02) (mean +/- sem). Quantitative assessment of depression correlated independently with total body BMD (r = -0.4; P < 0.05) and LS BMD (r = -0.6; P < 0.001).


CONCLUSIONS
Anorexic girls with depression are at higher risk of osteoporosis than those without depression. The mechanisms responsible for decreased BMD in depression are not known. Independent treatment of the depressive disorder in AN may partly alleviate the bone fragility.
Konstantynowicz
Jerzy
J
Department of Pediatrics and Auxology, Medical University of Bialystok, University Children's Hospital Dr. Ludwik Zamenhof, 15-274 Bialystok, Poland. jerzyk@unimelb.edu.au
Kadziela-Olech
Halina
H
Kaczmarski
Maciej
M
Zebaze
Roger M D
RM
Iuliano-Burns
Sandra
S
Piotrowska-Jastrzebska
Janina
J
Seeman
Ego
E
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D015519:Bone Density; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications* / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000378:metabolism; D010024:Osteoporosis / Q000209:etiology* / Q000378:metabolism; D012307:Risk Factors