Relationships between serum adipokines, insulin levels, and bone density in girls with anorexia nervosa.
BACKGROUND
Adolescents with anorexia nervosa (AN) have low bone mineral density (BMD). Adipokines and insulin play an important role in bone metabolism in healthy individuals. However, their association with bone metabolism in AN is unknown.


OBJECTIVE
The aim of the study was to determine whether adipokines and insulin are independently associated with measures of BMD in adolescents with AN and controls.


METHODS
Levels of adiponectin and insulin, fasting and after oral glucose, were evaluated in 17 AN patients and 19 controls (age, 12-18 yr), in whom hormonal parameters [GH, IGF-I, cortisol, estradiol, leptin, ghrelin, and peptide YY (PYY)] had been previously determined. Body composition, bone mineral content, and BMD at the lumbar spine, hip, femoral neck, and total body were assessed by dual energy x-ray absorptiometry. Two bone formation and bone resorption markers were examined.


METHODS
The study was conducted at a General Clinical Research Center.


RESULTS
Adiponectin differed between AN subjects and controls after controlling for fat mass and decreased in both after oral glucose (P = 0.02 and 0.07). On regression modeling, independent associations were observed of: 1) body mass index and adiponectin with lumbar spine bone mineral apparent density Z-scores (r(2) = 0.45); 2) lean mass, PYY, and ghrelin with hip Z-scores (r(2) = 0.55); 3) adiponectin and lean mass with femoral neck-bone mineral apparent density Z-scores (r(2) = 0.34); and 4) lean mass, PYY, GH, and ghrelin with total body-bone mineral content/height Z-scores (r(2) = 0.64), for the combined group. Adiponectin was also independently associated with BMD, and insulin was associated with bone turnover markers in the groups considered separately.


CONCLUSIONS
Adiponectin contributes significantly to the variability of bone density, and insulin contributes to bone turnover markers in adolescent girls.
Misra
Madhusmita
M
Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA 02114, USA. mmisra@partners.org
Miller
Karen K
KK
Cord
Jennalee
J
Prabhakaran
Rajani
R
Herzog
David B
DB
Goldstein
Mark
M
Katzman
Debra K
DK
Klibanski
Anne
A
D052242:Adiponectin / Q000097:blood; D000293:Adolescent; D000856:Anorexia Nervosa / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D004958:Estradiol / Q000097:blood; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D019894:Peptide YY / Q000097:blood; D012044:Regression Analysis; D015430:Weight Gain
C499918:ADIPOQ protein, human; D052242:Adiponectin; D001786:Blood Glucose; D007328:Insulin; D019894:Peptide YY; D019382:Human Growth Hormone; D004958:Estradiol; D007334:Insulin-Like Growth Factor I; D006854:Hydrocortisone