[Bone metabolism and fracture risk in anorexia nervosa].
The prevalence of anorexia nervosa has increased in recent years and a large proportion of patients with this disorder have low bone density at diagnosis and, therefore, an increased risk of early and late fractures. The mechanism of bone loss in anorexia nervosa is not well understood, yet it likely includes hypogonadism, alterations of the GH-IGF-1 axis and hypercortisolism. DEXA is the most effective tool for assessing and monitoring bone density in these patients, and it is important to improve or at least stabilize bone metabolism in those with low bone mass. No agent has yet been proven to be effective in improving bone density. However, sustained weight recovery and menses besides an adequate intake of calcium and vitamin D are recommended to optimize the conditions in which bone mass accrual may occur.
Fernández Soto
María Luisa
ML
Servicio de Endocrinología y Nutrición, Unidad de Nutrición Clínica y Dietética, Hospital Universitario San Cecilio, Granada, España. mlfernan@ugr.es
González Jiménez
Amalia
A
Varsavsky
Mariela
M
D000273:Adipose Tissue / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications / Q000188:drug therapy / Q000378:metabolism* / Q000628:therapy; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000627:therapeutic use; D003480:Cushing Syndrome / Q000209:etiology / Q000378:metabolism; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D012739:Gonadal Steroid Hormones / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D007006:Hypogonadism / Q000209:etiology / Q000378:metabolism; D036341:Intercellular Signaling Peptides and Proteins / Q000378:metabolism; D020738:Leptin / Q000502:physiology; D008297:Male; D008903:Minerals / Q000378:metabolism*; D010024:Osteoporosis / Q000188:drug therapy / Q000209:etiology* / Q000378:metabolism; D014807:Vitamin D / Q000627:therapeutic use; D055815:Young Adult
D050071:Bone Density Conservation Agents; D012739:Gonadal Steroid Hormones; D036341:Intercellular Signaling Peptides and Proteins; D020738:Leptin; D008903:Minerals; D014807:Vitamin D; D002118:Calcium