scholarly journals Use of SSRIs May Impact Bone Density in Adolescent and Young Women With Anorexia Nervosa

CNS Spectrums ◽  
2010 ◽  
Vol 15 (9) ◽  
pp. 579-586 ◽  
Author(s):  
Madhusmita Misra ◽  
Marie Le Clair ◽  
Nara Mendes ◽  
Karen K. Miller ◽  
Elizabeth Lawson ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Bone Mineral ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Mineral Content ◽  
Whole Body ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Hip Bmd ◽  
Z Scores ◽  
Negative Predictor

ABSTRACTObjectives: Alterations in serotonin impact bone metabolism in animal models, and selective serotonin reuptake inhibitors (SSRIs) have been associated with increased fracture risk in older adults. SSRIs are commonly used in anorexia nervosa (AN), a condition that predisposes to low bone mineral density (BMD). Our objective was to determine whether SSRI use is associated with low BMD in AN.Methods: We examined Z-scores for spine, hip, and whole body (WB) BMD, spine bone mineral apparent density, and WB bone mineral content/height (BMC/Ht) in females 12–21 years of age with AN who had never been on SSRIs, had been on SSRIs for <6 months (<6M), or had been on SSRIs for >6 months (>6M).Results: Subjects on SSRIs for >6M had lower spine, femoral-neck, and WBBMD Z-scores than those on SSRIs for <6M. Hip BMD and WBBMC/Ht Z-scores were lowest in subjects on SSRIs for >6M. Duration of SSRI use, duration since AN diagnosis and duration of amenorrhea inversely predicted BMD, whereas BMI was a positive predictor. In a regression model, duration of SSRI use remained an independent negative predictor of BMD.Discussion: Duration of SSRI use >6M is associated with low BMD in AN.Conclusion: It may be necessary to monitor BMD more rigorously when duration of SSRI use exceeds 6M.

Decreased Bone Density in Adolescent Girls With Anorexia Nervosa

PEDIATRICS ◽  
1990 ◽  
Vol 86 (3) ◽  
pp. 440-447 ◽  
Author(s):  
Laura K. Bachrach ◽  
David Guido ◽  
Debra Katzman ◽  
Iris F. Litt ◽  
Robert Marcus
Keyword(s):  
Bone Mineral Density ◽  
Body Mass Index ◽  
Anorexia Nervosa ◽  
Bone Density ◽  
Bone Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Whole Body ◽  
Mineral Density ◽  
Control Subjects

Osteoporosis develops in women with chronic anorexia nervosa. To determine whether bone mass is reduced in younger patients as well, bone density was studied in a group of adolescent patients with anorexia nervosa. With single- and dual-photon absorptiometry, a comparison was made of bone mineral density of midradius, lumbar spine, and whole body in 18 girls (12 to 20 years of age) with anorexia nervosa and 25 healthy control subjects of comparable age. Patients had significantly lower lumbar vertebral bone density than did control subjects (0.830 ± 0.140 vs 1.054 ± 0.139 g/cm2) and significantly lower whole body bone mass (0.700 ± 0.130 vs 0.955 ± 0.130 g/cm2). Midradius bone density was not significantly reduced. Of 18 patients, 12 had bone density greater than 2 standard deviations less than normal values for age. The diagnosis of anorexia nervosa had been made less than 1 year earlier for half of these girls. Body mass index correlated significantly with bone mass in girls who were not anorexic (P &lt; .05, .005, and .0001 for lumbar, radius, and whole body, respectively). Bone mineral correlated significantly with body mass index in patients with anorexia nervosa as well. In addition, age at onset and duration of anorexia nervosa, but not calcium intake, activity level, or duration of amenorrhea correlated significantly with bone mineral density. It was concluded that important deficits of bone mass occur as a frequent and often early complication of anorexia nervosa in adolescence. Whole body is considerably more sensitive than midradius bone density as a measure of cortical bone loss in this illness. Low body mass index is an important predictor of this reduction in bone mass.

scholarly journals The Effects of a High-Protein Diet on Bone Mineral Density in Exercise-Trained Women: A 1-Year Investigation

2018 ◽  
Vol 3 (4) ◽  
pp. 62
Author(s):  
Jose Antonio ◽  
Anya Ellerbroek ◽  
Cassandra Carson
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Bone Mineral ◽  
Mineral Content ◽  
High Protein Diet ◽  
High Protein ◽  
Protein Diet ◽  
Whole Body ◽  
Mineral Density ◽  
One Year

The effects of long-term high-protein consumption (i.e., >2.2 g/kg/day) are unclear as it relates to bone mineral content. Thus, the primary endpoint of this investigation was to determine if consuming a high-protein diet for one year affected various parameters of body composition in exercise-trained women. This investigation is a follow-up to a prior 6-month study. Subjects were instructed to consume a high-protein diet (>2.2 g/kg/day) for one year. Body composition was assessed via dual-energy X-ray absorptiometry (DXA). Subjects were instructed to keep a food diary (i.e., log their food ~three days per week for a year) via the mobile app MyFitnessPal®. Furthermore, a subset of subjects had their blood analyzed (i.e., basic metabolic panel). Subjects consumed a high-protein diet for one year (mean ± SD: 2.3 ± 1.1 grams per kilogram body weight daily [g/kg/day]). There were no significant changes for any measure of body composition over the course of the year (i.e., body weight, fat mass, lean body mass, percent fat, whole body bone mineral content, whole body T-score, whole body bone mineral density, lumbar bone mineral content, lumbar bone mineral density and lumbar T-score). In addition, we found no adverse effects on kidney function. Based on this 1-year within-subjects investigation, it is evident that a diet high in protein has no adverse effects on bone mineral density or kidney function.

Effects of vitamin D and estrogen receptor polymorphisms on bone mineral density in adolescents with anorexia nervosa

2019 ◽  
Vol 32 (12) ◽  
pp. 1377-1384
Author(s):  
Işıl İnan-Erdoğan ◽  
Sinem Akgül ◽  
Kübra Işgın-Atıcı ◽  
Tuğba Tuğrul-Yücel ◽  
Koray Boduroğlu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Estrogen Receptor ◽  
Anorexia Nervosa ◽  
Bone Mineral ◽  
Mineral Density ◽  
Vdr Gene ◽  
Positive Effects ◽  
Z Scores ◽  
Positive Effect

Abstract Background Anorexia nervosa (AN) is a serious eating disorder that is associated with decreased bone mineral density (BMD) and greater lifetime risk for fractures. The aim of this study was to determine the correlation between BMD and genetic polymorphisms in AN. Methods This case-control study analyzed vitamin D receptor (VDR) (VDRBsml, VDRFokl) and estrogen receptor (ESR) (ESR1Xbal, ESR1Pvull) polymorphisms in 45 adolescents diagnosed with AN and 46 age-matched healthy controls. BMD values of the AN group were classified as low or normal, and polymorphisms were compared between cases and controls. The effects of body mass index (BMI), duration of disease and amenorrhea on BMD were also evaluated. Results In girls with AN, a positive effect of the bb genotype of VDRBsmI polymorphism on femur Z-scores (p = 0.103) and of the Ff genotype of VDRFokI polymorphism on vertebra Z-scores (p = 0.097) was observed. In boys with AN, a positive effect of the Ff genotype of VDRFokI polymorphism on vertebra BMD (g/cm2) was detected (p = 0.061). No association was detected between ESR polymorphisms. An inverse relationship was observed between BMD and duration of illness and amenorrhea. A direct relationship was detected between BMD and BMI. Conclusions Specific VDR gene polymorphism genotypes may have positive effects on BMD in patients with AN. Additionally, the lack of association between ESR gene polymorphisms on BMD could be attributed to the low estrogen status of the patient.

scholarly journals Older age at Initiation of Antiretroviral Therapy Predicts Low Bone Mineral Density in Children with perinatally-infected HIV in Zimbabwe

2019 ◽  
Author(s):  
Celia L Gregson ◽  
April Hartley ◽  
Edith Majonga ◽  
Grace Mchugh ◽  
Nicola Crabtree ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Bone Density ◽  
Bone Mineral ◽  
Lean Mass ◽  
Muscle Development ◽  
Z Score ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Art Initiation ◽  
Z Scores

AbstractBackgroundPerinatally-acquired HIV infection commonly causes stunting in children, but how this affects bone and muscle development is unclear. We investigated differences in bone and muscle mass and muscle function between children with HIV (CWH) and uninfected children.SettingCross-sectional study of CWH (6–16 years) receiving antiretroviral therapy (ART) for >6 months and children in the same age-group testing HIV-negative at primary health clinics in Zimbabwe.MethodsFrom Dual-energy X-ray Absorptiometry (DXA) we calculated total-body less-head (TBLH) Bone Mineral Content (BMC) for lean mass adjusted-for-height (TBLH-BMCLBM) Z-scores, and lumbar spine (LS) Bone Mineral Apparent Density (BMAD) Z-scores.ResultsThe 97 CWH were older (mean age 12.7 vs. 10.0 years) and therefore taller (mean height 142cm vs. 134cm) than those 77 uninfected. However, stunting (height-for-age Z-score≤-2) was more prevalent in CWH (35% vs. 5%, p<0.001). Amongst CWH, 15% had low LS-BMAD (Z-score ≤-2) and 13% had low TBLH-BMCLBM, vs. 1% and 3% respectively in those uninfected (both p≤0.02). After age, sex, height and puberty adjustment, LS-BMAD was 0.33 SDs (95%CI −0.01, 0.67; p=0.06) lower in CWH, with no differences in TBLH-BMCLBM, lean mass or grip strength by HIV status. However, there was a strong relationship between age at ART initiation and both LS-BMAD Z-score (r=-0.33, p=0.001) and TBLH-BMCLBM Z-score (r=-0.23, p=0.027); for each year ART initiation was delayed a 0.13 SD reduction in LS-BMAD was seen.ConclusionSize-adjusted low bone density is common in CWH. Delay in initiating ART adversely affects bone density. Findings support immediate ART initiation at HIV diagnosis.

scholarly journals Bone mineral density in children and young adults with neurofibromatosis type 1

2012 ◽  
Vol 19 (6) ◽  
pp. 817-825 ◽  
Author(s):  
Maya B Lodish ◽  
Urania Dagalakis ◽  
Ninet Sinaii ◽  
Ethan Bornstein ◽  
AeRang Kim ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Neurofibromatosis Type 1 ◽  
Plexiform Neurofibroma ◽  
Neurofibromatosis Type ◽  
Whole Body ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Total Body

Concern for impaired bone health in children with neurofibromatosis type 1 (NF-1) has led to increased interest in bone densitometry in this population. Our study assessed bone mineral apparent density (BMAD) and whole-body bone mineral content (BMC)/height in pediatric patients with NF-1 with a high plexiform neurofibroma burden. Sixty-nine patients with NF-1 (age range 5.2–24.8; mean 13.7±4.8 years) were studied. Hologic dual-energy X-ray absorptiometry scans (Hologic, Inc., Bedford, MA, USA) were performed on all patients. BMD was normalized to derive a reference volume by correcting for height through the use of the BMAD, as well as the BMC. BMAD of the lumbar spine (LS 2–4), femoral neck (FN), and total body BMC/height were measured and Z-scores were calculated. Impaired bone mineral density was defined as a Z-score ≤−2. Forty-seven percent of patients exhibited impaired bone mineral density at any bone site, with 36% at the LS, 18% at the FN, and 20% total BMC/height. BMAD Z-scores of the LS (−1.60±1.26) were more impaired compared with both the FN (−0.54±1.58; P=0.0003) and the whole-body BMC/height Z-scores (−1.16±0.90; P=0.036). Plexiform neurofibroma burden was negatively correlated with LS BMAD (rs=−0.36, P=0.01). In pediatric and young adult patients with NF-1, LS BMAD was more severely affected than the FN BMAD or whole-body BMC/height.

Relation of bone mineral density and content to mineral content and density of the fat-free mass

2001 ◽  
Vol 91 (5) ◽  
pp. 2166-2172 ◽  
Author(s):  
Ellen M. Evans ◽  
Barry M. Prior ◽  
Sigurbjorn A. Arngrimsson ◽  
Christopher M. Modlesky ◽  
Kirk J. Cureton
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mineral Content ◽  
Collegiate Athletes ◽  
Fat Free Mass ◽  
Whole Body ◽  
Mineral Density ◽  
Athletic Status ◽  
Four Component Model ◽  
Hydrostatic Weighing

Differences in the mineral fraction of the fat-free mass (MFFM) and in the density of the FFM (DFFM) are often inferred from measures of bone mineral content (BMC) or bone mineral density (BMD). We studied the relation of BMC and BMD to the MFFM and DFFM in a heterogeneous sample of 216 young men ( n = 115) and women ( n = 101), which included whites ( n = 155) and blacks ( n = 61) and collegiate athletes ( n = 132) and nonathletes ( n = 84). Whole body BMC and BMD were determined by dual-energy X-ray absorptiometry (DXA; Hologic QDR-1000W, enhanced whole body analysis software, version 5.71). FFM was estimated using a four-component model from measures of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by DXA. There was no significant relation of BMD to MFFM( r = 0.01) or DFFM ( r = −0.06) or of BMC to MFFM ( r = −0.11) and a significant, weak negative relation of BMC to DFFM( r = −0.14, P = 0.04) in all subjects. Significant low to moderate relationships of BMD or BMC to MFFM or DFFM were found within some gender-race-athletic status subgroups or when the effects of gender, race, and athletic status were held constant using multiple regression, but BMD and BMC explained only 10–17% of the variance in MFFM and 0–2% of the variance in DFFM in addition to that explained by the demographic variables. We conclude that there is not a significant positive relation of BMD and BMC to MFFM or DFFM in young adults and that BMC and BMD should not be used to infer differences in MFFM or DFFM.

Effect of suppression of puberty and cross-sex hormone therapy on bone turnover markers and BMAD in transgender adolescents

2016 ◽  
Vol 62 (5) ◽  
pp. 22-23
Author(s):  
Mariska Caroline Vlot ◽  
Daniel T. Klink ◽  
Martin Den Heijer ◽  
Marinus A. Blankenstein ◽  
Joost Rotteveel ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Hormone Therapy ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Sex Hormone ◽  
Added Value ◽  
Mineral Density ◽  
Bone Mineral Apparent Density ◽  
Z Scores ◽  
Turnover Markers

Background: Puberty is highly important for the accumulation of bone mass. Bone turnover and bone mineral density can be affected in transgender adolescents when puberty is suppressed by gonadotropin-releasing hormone analogues (GnRHa), followed by treatment with cross-sex hormone therapy (CSHT).Objective: To investigate the effect of GnRHa and CSHT on bone turnover markers (BTMs) and bone mineral apparent density (BMAD) in transgender adolescents.Methods: Thirty four female-to-males (FtMs) and 22 male-to-females (MtFs) were divided into a young and old pubertal group, based on the bone age of 14 years in the FtMs and 15 years in the MtFs. All patients received GnRHa triptorelin. CSHT was prescribed in incremental doses from the age of 16 years. FtMs received testosterone ester mixture and MtFs were treated with 17-β estradiol. BTMs P1NP, osteocalcin and ICTP and the BMD of lumbar spine (LS) and femoral neck (FN) were measured at three time points. Furthermore, BMAD and Z-scores were calculated.Results: P1NP and 1CTP decreased during GnRHa treatment, indicating decreased bone turnover. Osteocalcin showed an aberrant pattern. A low BMAD Z-score of both FN and LS was observed in the MtFs at start of GnRHa treatment. The decrease in bone turnover upon GnRHa treatment was accompanied by an unchanged BMAD of both FN and LS, however BMAD Z-scores of predominantly the LS decreased. Twenty-four months after CSHT the BTMs P1NP and ICTP were even more decreased. During CSHT BMAD Z-scores increased and returned towards normal, especially of the LS.Conclusion: Suppressing puberty by GnRHa leads to a decrease of BTMs in transgender adolescents. The increase of BMAD and BMAD Z-scores predominantly in the LS as a result of treatment with CSHT is accompanied by decreasing BTM concentrations after 24 months of CSHT. Therefore, the added value of evaluating BTMs seems to be limited and DEXA-scans remain important in follow-up of transgender adolescents. 

scholarly journals Daily Treatment with Human Recombinant Parathyroid Hormone-(1–34), LY333334, for 1 Year Increases Bone Mass in Ovariectomized Monkeys*

1999 ◽  
Vol 84 (10) ◽  
pp. 3757-3763 ◽  
Author(s):  
Robert Brommage ◽  
Charlotte E. Hotchkiss ◽  
Cynthia J. Lees ◽  
Melanie W. Stancill ◽  
Janet M. Hock ◽  
...  
Keyword(s):  
Bone Mass ◽  
Bone Mineral Content ◽  
Bone Mineral ◽  
Mineral Content ◽  
Proximal Tibia ◽  
Whole Body ◽  
Mineral Density ◽  
Increase Bone Mass ◽  
Skeletal Effects ◽  
Body Bone

AbstractPTH stimulates bone formation to increase bone mass and strength in rats and humans. The aim of this study was to determine the skeletal effects of recombinant human PTH-(1–34) [rhPTH-(1–34)] in monkeys, as monkey bone remodeling and structure are similar to those in human bone.Adult female cynomolgus monkeys were divided into sham-vehicle (n= 21), ovariectomized (OVX)-vehicle (n = 20), and OVX groups given daily sc injections of rhPTH-(1–34) at 1 (n = 39) or 5 (n = 41) μg/kg for 12 months. Whole body bone mineral content was measured, as was bone mineral density (BMD) in the spine, proximal tibia, midshaft radius, and distal radius. Serum and urine samples were also analyzed. rhPTH-(1–34) treatment did not influence serum ionized Ca levels or urinary Ca excretion, but depressed endogenous PTH while increasing serum calcitriol levels. Compared to that in the OVX group, the higher dose of rhPTH-(1–34) increased spine BMD by 14.3%, whole body bone mineral content by 8.6%, and proximal tibia BMD by 10.8%. Subregion analyses suggested that the anabolic effect of rhPTH-(1–34) on the proximal tibia was primarily in cancellous bone. Similar, but less dramatic, effects on BMD were observed with the lower dose of rhPTH-(1–34). Daily sc rhPTH-(1–34) treatment for 1 yr increases BMD in ovariectomized monkeys without inducing sustained hypercalcemia or hypercalciuria.

scholarly journals Abnormal bone mineral density and content in girls with early-onset anorexia nervosa

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Julia Clarke ◽  
Hugo Peyre ◽  
Marianne Alison ◽  
Anne Bargiacchi ◽  
Coline Stordeur ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Anorexia Nervosa ◽  
Lean Body Mass ◽  
Body Mass ◽  
Bone Mineral ◽  
Mineral Content ◽  
Mineral Density ◽  
Total Body ◽  
Total Body Bone Mineral ◽  
Body Bone

Abstract Background Early-onset anorexia nervosa (EO-AN) represents a significant clinical burden to paediatric and mental health services. The impact of EO-AN on bone mineral abnormalities has not been thoroughly investigated due to inadequate control for pubertal status. In this study, we investigated bone mineral abnormalities in girls with EO-AN regardless of pubertal development stage. Method We conducted a cross-sectional study of 67 girls with EO-AN (median age = 12.4 [10.9–13.7 years]) after a median duration of disease of 1.3 [0.6–2.0] years, and 67 healthy age-, sex-, pubertal status- matched control subjects. We compared relevant bone mineral parameters between groups: the total body bone mineral density [TB-BMD], the lumbar spine BMD [LS-BMD], the total body bone mineral content [TB-BMC] and the ratio of the TB-BMC to lean body mass [TB-BMC/LBM]. Results TB-BMD, TB-BMC, LS-BMD and TB-BMC/LBM were all significantly lower in patients with AN compared to controls. In the EO-AN group, older age, later pubertal stages and higher lean body mass were associated with higher TB-BMC, TB-BMD, and LS-BMD values. Discussion Girls with EO-AN displayed deficits in bone mineral content and density after adjustment for pubertal maturation. Age, higher pubertal stage and lean body mass were identified as determinants of bone maturation in the clinical population of patients with EO-AN. Bone health should be promoted in patients, specifically in those with an onset of disorder before 14 years old and with a delayed puberty.

scholarly journals Selective Determinants of Low Bone Mineral Mass in Adult Women with Anorexia Nervosa

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Andrea Trombetti ◽  
Laura Richert ◽  
François R. Herrmann ◽  
Thierry Chevalley ◽  
Jean-Daniel Graf ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Lumbar Spine ◽  
Bone Mineral ◽  
Apparent Density ◽  
Proximal Femur ◽  
Control Group ◽  
Adult Women ◽  
Mineral Density ◽  
Hip Geometry ◽  
Bone Mineral Apparent Density

We investigated the relative effect of amenorrhea and insulin-like growth factor-I (sIGF-I) levels on cancellous and cortical bone density and size. We investigated 66 adult women with anorexia nervosa. Lumbar spine and proximal femur bone mineral density was measured by DXA. We calculated bone mineral apparent density. Structural geometry of the spine and the hip was determined from DXA images. Weight and BMI, but not height, as well as bone mineral content and density, but not area and geometry parameters, were lower in patients with anorexia nervosa as compared with the control group. Amenorrhea, disease duration, and sIGF-I were significantly associated with lumbar spine and proximal femur BMD. In a multiple regression model, we found that sIGF-I was the only significant independent predictor of proximal femur BMD, while duration of amenorrhea was the only factor associated with lumbar spine BMD. Finally, femoral neck bone mineral apparent density, but not hip geometry variables, was correlated with sIGF-I. In anorexia nervosa, spine BMD was related to hypogonadism, whereas sIGF-I predicted proximal femur BMD. The site-specific effect of sIGF-I could be related to reduced volumetric BMD rather than to modified hip geometry.

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