Tags

Type your tag names separated by a space and hit enter

A systematic review and meta-analysis of the association between eating disorders and bone density.

Abstract

This meta-analysis investigates the effect of an eating disorder on bone mineral density in two eating disorder subtypes. Following conflicting findings in previous literature, this study finds that not only anorexia nervosa, but also bulimia nervosa has a detrimental effect on BMD. Key predictors of this relationship are discussed. This systematic review and meta-analysis investigates bone mineral density (BMD) in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) in comparison to healthy controls (HCs). AN has been associated with low BMD and a risk of fractures and mixed results have been obtained for the relationship between BN and BMD. Deciphering the effect these two ED subtypes on BMD will determine the effect of low body weight (a characteristic of AN) versus the effects of periods of restrictive eating and malnutrition which are common to both AN and BN. We conducted a systematic search through the electronic databases MedLine, EMBASE and PsychInfo and the Cochrane Library to investigate and quantify this relationship. We screened 544 articles and included 27 studies in a random-effect meta-analysis and calculated the standardised mean difference (SMD) in BMD between women with a current diagnosis of AN (n = 785) vs HCs (n = 979) and a current diagnosis of BN (n = 187) vs HCs (n = 350). The outcome measures investigated were spinal, hip, femoral neck and whole body BMD measured by DXA or DPA scanning. A meta-regression investigated the effect of factors including age, duration since diagnosis, duration of amenorrhea and BMI on BMD. The mean BMI of participants was 16.65 kg/m(2) (AN), 21.16 kg/m(2) (BN) and 22.06 kg/m(2) (HC). Spine BMD was lowest in AN subjects (SMD, -3.681; 95 % CI, -4.738, -2.625; p < 0.0001), but also lower in BN subjects compared with HCs (SMD, -0.472; 95 % CI, -0.688, -0.255; p < 0.0001). Hip, whole body and femoral neck BMD were reduced to a statistically significant level in AN but not BN groups. The meta-regression was limited by the number of included studies and did not find any significant predictors. This meta-analysis confirms the association between low BMD and AN and presents a strong argument for assessing BMD not only in patients with AN, but also in patients with BN.

Links

  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Institute of Child Health, University College London, Gower Street, London, WC1E 6BT, UK. Lauren.robinson.14@ucl.ac.uk.

    ,

    Institute of Child Health, University College London, Gower Street, London, WC1E 6BT, UK.

    ,

    Musculoskeletal Research Unit, University of Bristol, Bristol, UK.

    ,

    Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, 02114, USA.

    Institute of Child Health, University College London, Gower Street, London, WC1E 6BT, UK. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA.

    Source

    MeSH

    Anorexia Nervosa
    Bone Density
    Bulimia Nervosa
    Female
    Humans
    Osteoporosis

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    26782684

    Citation

    Robinson, L, et al. "A Systematic Review and Meta-analysis of the Association Between Eating Disorders and Bone Density." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 27, no. 6, 2016, pp. 1953-66.
    Robinson L, Aldridge V, Clark EM, et al. A systematic review and meta-analysis of the association between eating disorders and bone density. Osteoporos Int. 2016;27(6):1953-66.
    Robinson, L., Aldridge, V., Clark, E. M., Misra, M., & Micali, N. (2016). A systematic review and meta-analysis of the association between eating disorders and bone density. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 27(6), pp. 1953-66. doi:10.1007/s00198-015-3468-4.
    Robinson L, et al. A Systematic Review and Meta-analysis of the Association Between Eating Disorders and Bone Density. Osteoporos Int. 2016;27(6):1953-66. PubMed PMID: 26782684.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A systematic review and meta-analysis of the association between eating disorders and bone density. AU - Robinson,L, AU - Aldridge,V, AU - Clark,E M, AU - Misra,M, AU - Micali,N, Y1 - 2016/01/18/ PY - 2015/07/01/received PY - 2015/12/16/accepted PY - 2016/1/20/entrez PY - 2016/1/20/pubmed PY - 2018/3/20/medline KW - Anorexia nervosa KW - Bone KW - Bone density KW - Bulimia nervosa KW - Eating disorder KW - Osteoporosis SP - 1953 EP - 66 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 27 IS - 6 N2 - This meta-analysis investigates the effect of an eating disorder on bone mineral density in two eating disorder subtypes. Following conflicting findings in previous literature, this study finds that not only anorexia nervosa, but also bulimia nervosa has a detrimental effect on BMD. Key predictors of this relationship are discussed. This systematic review and meta-analysis investigates bone mineral density (BMD) in individuals with anorexia nervosa (AN) and bulimia nervosa (BN) in comparison to healthy controls (HCs). AN has been associated with low BMD and a risk of fractures and mixed results have been obtained for the relationship between BN and BMD. Deciphering the effect these two ED subtypes on BMD will determine the effect of low body weight (a characteristic of AN) versus the effects of periods of restrictive eating and malnutrition which are common to both AN and BN. We conducted a systematic search through the electronic databases MedLine, EMBASE and PsychInfo and the Cochrane Library to investigate and quantify this relationship. We screened 544 articles and included 27 studies in a random-effect meta-analysis and calculated the standardised mean difference (SMD) in BMD between women with a current diagnosis of AN (n = 785) vs HCs (n = 979) and a current diagnosis of BN (n = 187) vs HCs (n = 350). The outcome measures investigated were spinal, hip, femoral neck and whole body BMD measured by DXA or DPA scanning. A meta-regression investigated the effect of factors including age, duration since diagnosis, duration of amenorrhea and BMI on BMD. The mean BMI of participants was 16.65 kg/m(2) (AN), 21.16 kg/m(2) (BN) and 22.06 kg/m(2) (HC). Spine BMD was lowest in AN subjects (SMD, -3.681; 95 % CI, -4.738, -2.625; p < 0.0001), but also lower in BN subjects compared with HCs (SMD, -0.472; 95 % CI, -0.688, -0.255; p < 0.0001). Hip, whole body and femoral neck BMD were reduced to a statistically significant level in AN but not BN groups. The meta-regression was limited by the number of included studies and did not find any significant predictors. This meta-analysis confirms the association between low BMD and AN and presents a strong argument for assessing BMD not only in patients with AN, but also in patients with BN. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/26782684/full_citation L2 - https://dx.doi.org/10.1007/s00198-015-3468-4 DB - PRIME DP - Unbound Medicine ER -