title: The neuroendocrine basis of anorexia nervosa and its impact on bone metabolism.
abstract: Anorexia nervosa (AN) is a condition of profound undernutrition associated with alterations in various neuroendocrine axes, many of which contribute to a marked impairment in bone accrual and low bone mineral density. This review focuses on changes in the hypothalamo-pituitary-gonadal axis, the growth hormone insulin-like growth factor-1 axis, and the hypothalamo-pituitary-adrenal axis in AN, as well as alterations in various appetite-regulating hormones. In addition, the review discusses low bone mineral density and altered bone microarchitecture in AN, the pathophysiology underlying impaired bone metabolism, and possible therapeutic strategies to optimize bone health.
authors.affiliation: Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA. mmisra@partners.org
authors.forename: Madhusmita
authors.initials: M
authors.lastname: Misra
authors.forename: Anne
authors.initials: A
authors.lastname: Klibanski
mesh_terms: D000856:Anorexia Nervosa / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology*; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001842:Bone and Bones / Q000033:anatomy & histology / Q000378:metabolism* / Q000503:physiopathology*; D042341:Gonadal Hormones / Q000378:metabolism; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism* / Q000503:physiopathology*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D013963:Thyroid Hormones / Q000378:metabolism
chemical_list: D050071:Bone Density Conservation Agents; D042341:Gonadal Hormones; D013963:Thyroid Hormones; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I