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Changes in bone turnover in patients with anorexia nervosa during eleven weeks of inpatient dietary treatment.

Abstract

BACKGROUND

Many adolescents with anorexia nervosa suffer from severe osteopenia and osteoporosis. We hypothesized that individualized nutrition therapy may improve bone turnover in anorectic patients.

METHODS

We studied 19 female patients [mean age, 14.2 +/- 1.4 years; mean body weight, 39.3 +/- 5.4 kg; mean body mass index (BMI), 14.2 +/- 1.4 kg/m(2)] with anorexia nervosa (International Classification of Diseases-10: F50.0, F50.1) for a period of 3 months. Nutrition therapy began at the end of the first week and included individualized hypercaloric diets, high calcium intake (2000 mg/day), and administration of vitamin D (400 IU/day). Blood samples were taken at baseline and again in weeks 3, 7, and 11. We measured serum calcium, parathyroid hormone, bone formation and resorption markers, insulin-like growth factor 1 (IGF-1), and leptin.

RESULTS

Mean BMI increased significantly, from 14.2 +/- 1.4 to 17.1 +/- 0.7 kg/m(2) (P = 0.000001), during the course of treatment, whereas serum total calcium and phosphate concentrations remained unchanged. The bone formation markers procollagen-I carboxy-terminal propeptide and bone alkaline phosphatase almost doubled (P = 0.006). Both IGF-1 (P = 0.00001) and leptin (P = 0.000005) increased significantly by week 11. Parallel to this, the serum concentration of C-telopeptide, a bone resorption marker, decreased significantly (P = 0.009).

CONCLUSIONS

Nutritional rehabilitation, possibly as a result of increasing IGF-1 and leptin concentrations, may increase bone formation. It therefore provides additional objective evidence of the importance of nutrition for bone.

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  • Authors+Show Affiliations

    ,

    DLR-Institute of Aerospace Medicine, Space Physiology, 51170 Cologne, Germany. martina.heer@dlr.de

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    Source

    Clinical chemistry 48:5 2002 May pg 754-60

    MeSH

    Adolescent
    Anorexia Nervosa
    Biomarkers
    Bone and Bones
    Child
    Female
    Humans
    Inpatients
    Osteogenesis
    Time Factors
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11978602

    Citation

    Heer, Martina, et al. "Changes in Bone Turnover in Patients With Anorexia Nervosa During Eleven Weeks of Inpatient Dietary Treatment." Clinical Chemistry, vol. 48, no. 5, 2002, pp. 754-60.
    Heer M, Mika C, Grzella I, et al. Changes in bone turnover in patients with anorexia nervosa during eleven weeks of inpatient dietary treatment. Clin Chem. 2002;48(5):754-60.
    Heer, M., Mika, C., Grzella, I., Drummer, C., & Herpertz-Dahlmann, B. (2002). Changes in bone turnover in patients with anorexia nervosa during eleven weeks of inpatient dietary treatment. Clinical Chemistry, 48(5), pp. 754-60.
    Heer M, et al. Changes in Bone Turnover in Patients With Anorexia Nervosa During Eleven Weeks of Inpatient Dietary Treatment. Clin Chem. 2002;48(5):754-60. PubMed PMID: 11978602.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Changes in bone turnover in patients with anorexia nervosa during eleven weeks of inpatient dietary treatment. AU - Heer,Martina, AU - Mika,Claudia, AU - Grzella,Ina, AU - Drummer,Christian, AU - Herpertz-Dahlmann,Beate, PY - 2002/4/30/pubmed PY - 2002/5/4/medline PY - 2002/4/30/entrez SP - 754 EP - 60 JF - Clinical chemistry JO - Clin. Chem. VL - 48 IS - 5 N2 - BACKGROUND: Many adolescents with anorexia nervosa suffer from severe osteopenia and osteoporosis. We hypothesized that individualized nutrition therapy may improve bone turnover in anorectic patients. METHODS: We studied 19 female patients [mean age, 14.2 +/- 1.4 years; mean body weight, 39.3 +/- 5.4 kg; mean body mass index (BMI), 14.2 +/- 1.4 kg/m(2)] with anorexia nervosa (International Classification of Diseases-10: F50.0, F50.1) for a period of 3 months. Nutrition therapy began at the end of the first week and included individualized hypercaloric diets, high calcium intake (2000 mg/day), and administration of vitamin D (400 IU/day). Blood samples were taken at baseline and again in weeks 3, 7, and 11. We measured serum calcium, parathyroid hormone, bone formation and resorption markers, insulin-like growth factor 1 (IGF-1), and leptin. RESULTS: Mean BMI increased significantly, from 14.2 +/- 1.4 to 17.1 +/- 0.7 kg/m(2) (P = 0.000001), during the course of treatment, whereas serum total calcium and phosphate concentrations remained unchanged. The bone formation markers procollagen-I carboxy-terminal propeptide and bone alkaline phosphatase almost doubled (P = 0.006). Both IGF-1 (P = 0.00001) and leptin (P = 0.000005) increased significantly by week 11. Parallel to this, the serum concentration of C-telopeptide, a bone resorption marker, decreased significantly (P = 0.009). CONCLUSIONS: Nutritional rehabilitation, possibly as a result of increasing IGF-1 and leptin concentrations, may increase bone formation. It therefore provides additional objective evidence of the importance of nutrition for bone. SN - 0009-9147 UR - https://www.unboundmedicine.com/medline/citation/11978602/full_citation L2 - http://www.clinchem.org/cgi/pmidlookup?view=long&pmid=11978602 DB - PRIME DP - Unbound Medicine ER -