Current concepts in bone and reproductive health in adolescents with anorexia nervosa.
Anorexia nervosa (AN) initiates an adaptive response at the level of the hypothalamus, which results in a complex interplay involving most elements of the neuroendocrine axis. Consequences of onset of disease in adolescence include amenorrhoea, pubertal arrest with potential loss of target height, and osteoporosis with reduced capacity for future attainment of peak bone mass. With recovery, delay in restoration of menses is common. Hormonal therapies for restoration of bone mineral density (BMD) in adolescents have shown limited efficacy. This review will discuss the reproductive endocrine effects of AN in adolescence, and discuss new investigative tools for monitoring restoration of reproductive function and BMD in this population.
Jayasinghe
Y
Y
Department of Gynaecology Royal Children's Hospital, Melbourne, Victoria, Australia. yasmin.jayasinghe@rch.org.au
Grover
S R
SR
Zacharin
M
M
D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications* / Q000503:physiopathology; D015519:Bone Density / Q000502:physiology*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001847:Bone Diseases / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D001862:Bone Resorption; D002118:Calcium / Q000008:administration & dosage; D003687:Dehydroepiandrosterone / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use; D015914:Estrogen Replacement Therapy / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D054439:Ghrelin / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000502:physiology; D007334:Insulin-Like Growth Factor I; D020738:Leptin / Q000378:metabolism / Q000627:therapeutic use; D010053:Ovary / Q000502:physiology; D019894:Peptide YY / Q000378:metabolism; D010913:Pituitary-Adrenal System / Q000502:physiology; D018456:Reproductive Medicine; D014807:Vitamin D / Q000008:administration & dosage; D015430:Weight Gain
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D054439:Ghrelin; D020738:Leptin; D019894:Peptide YY; D014807:Vitamin D; D003687:Dehydroepiandrosterone; D007334:Insulin-Like Growth Factor I; D002118:Calcium