Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy.
OBJECTIVE
Anorexia nervosa (AN) is associated with reduced bone mass and an increased fracture risk. The aim was to evaluate the vitamin D status and the association with body mass index (BMI), fat mass and bone mineral density (BMD) in patients with severe AN during a prospective intervention study of intensive nutrition therapy.


METHODS
This study comprised 25 Swedish female AN patients (20.1 ± 2.3 years), who were treated as inpatients for 12 weeks with a high-energy diet. Serum 25-hydroxyvitamin D (25(OH)D), calcium, phosphate and parathyroid hormone (PTH) were measured. BMD and body composition were assessed by dual-energy X-ray absorptiometry at study start and after 12 weeks.


RESULTS
Twenty-two patients completed the study. The mean weight gain was 9.9 kg and BMI (mean ± SD) increased from 15.5 ± 0.9 to 19.0 ± 0.9 kg/m2, P < 0.0001. Fat mass increased from median 12 to 27 %. The median serum 25(OH)D level was 84 nmol/L at baseline, which decreased to 76 nmol/L, P < 0.05. PTH increased from median 21.9 to 30.0 ng/L, P < 0.0001. BMC increased during the study period, P < 0.001.


CONCLUSIONS
Serum 25(OH)D levels were adequate both at study start and completion, however, nominally decreased after the 12-week nutritional intervention. PTH increased subsequently, which coincide with the decreased 25(OH)D levels. The reduction in 25(OH)D could be due to an increased storage of vitamin D related to the increase in fat mass since vitamin D is sequestered in adipose tissue.
Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, Sahlgrenska Academy, Gothenburg University, Rondvägen 15, SE-416 85, Göteborg, Sweden. anna.svedlund@vgregion.se.
Anna
http://orcid.org/0000-0001-5086-8009
A
Svedlund
Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden.
Cecilia
C
Pettersson
Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, Sahlgrenska Academy, Gothenburg University, Rondvägen 15, SE-416 85, Göteborg, Sweden.
Bojan
B
Tubic
Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Per
P
Magnusson
Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, Sahlgrenska Academy, Gothenburg University, Rondvägen 15, SE-416 85, Göteborg, Sweden.
Diana
D
Swolin-Eide
D015502:Absorptiometry, Photon; D000293:Adolescent; D000856:Anorexia Nervosa / Q000097:blood* / Q000178:diet therapy*; D001823:Body Composition; D015992:Body Mass Index; D015519:Bone Density; D002118:Calcium / Q000097:blood; D004032:Diet; D005260:Female; D006801:Humans; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D013548:Sweden; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood; D015430:Weight Gain; D044465:White People; D055815:Young Adult
D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D002118:Calcium
Anorexia nervosa; Bone; Nutrition therapy; Vitamin D