Prognostic indicators of changes in bone density measures in adolescent girls with anorexia nervosa-II.
BACKGROUND
Adolescents with anorexia nervosa (AN) have low bone mineral density (BMD). Baseline predictors of temporal BMD changes (DeltaBMD) in AN, including 1) gastrointestinal peptides regulating food intake and appetite that have been related to bone metabolism and 2) bone turnover markers, have not been well characterized. We hypothesized that baseline levels of nutritionally regulated hormones and of bone turnover markers would predict DeltaBMD overall.


METHODS
In a prospective observational study, lumbar and whole-body BMD was measured at 0, 6, and 12 months in 34 AN girls aged 12-18 yr and 33 controls. Baseline body mass index, lean mass, nutritionally regulated hormones [IGF-I, cortisol, ghrelin, leptin, and peptide YY (PYY)], bone formation, and resorption markers were examined to determine nutritional and hormonal predictors of bone density changes.


RESULTS
In a regression model, baseline ghrelin and PYY predicted changes in spine bone measures; and baseline ghrelin, cortisol, and PYY predicted changes in whole-body bone measures independent of baseline nutritional status.


CONCLUSIONS
Neuroendocrine gastrointestinal-derived peptides regulating food intake are independent predictors of changes in bone mass in AN.
Misra
Madhusmita
M
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA. mmisra@partners.org
Prabhakaran
Rajani
R
Miller
Karen K
KK
Goldstein
Mark A
MA
Mickley
Diane
D
Clauss
Laura
L
Lockhart
Patrice
P
Cord
Jennalee
J
Herzog
David B
DB
Katzman
Debra K
DK
Klibanski
Anne
A
D000293:Adolescent; D000856:Anorexia Nervosa / Q000378:metabolism*; D015992:Body Mass Index; D015519:Bone Density; D002648:Child; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D019894:Peptide YY / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies
D019894:Peptide YY; D019382:Human Growth Hormone