Longitudinal changes in bone parameters in young girls with anorexia nervosa

Shepherd, S., Kyriakou, A., Shaikh, M. G., McDevitt, H., Oakley, C., Thrower, M., Ahmed, S. F. and Mason, A. (2018) Longitudinal changes in bone parameters in young girls with anorexia nervosa. Bone, (doi: 10.1016/j.bone.2018.03.022) (PMID:29601899)

[img]
Preview
Text
160460.pdf - Accepted Version
Available under License Creative Commons Attribution Non-commercial No Derivatives.

1MB

Abstract

Background: Anorexia nervosa (AN) during childhood and adolescence has been reported to adversely affect bone health, but few studies have investigated longitudinal changes. Method: DXA-derived bone parameters and body composition were retrospectively assessed in 111 young girls with AN with a median age of 15.4 years (10.9, 19.8). In 68 (61%) vertebral fracture assessment (VFA) was performed and in 31 (28%), a follow-up DXA was performed. Correlations with growth, changes in body composition and effects of illness duration and menstruation were examined. Size adjusted DXA standard deviation scores were calculated for total body (TB) less head bone mineral content (TBLH-BMC) and lumbar spine bone mineral apparent density (LS-BMAD). Results: Mean (range) bone area (BA) for height centile was 27.1 (0–97), and mean lean mass for height centile was 28.8 (0–95) at baseline. Mean (range) LS BMAD was −1.0 (−2.6, 0.8) SDS at first and − 1.2 (−3.0, −0.2) at second DXA (p = 0.023). On follow up, lean mass for height increased from 27th centile (0, 75) to 40th centile (0, 70) (p = 0.006), and fat mass for height increased from 55 g/cm to 67 g/cm (11.3, 124.2) (p < 0.001). Duration of illness was the only negative predictor of LS BMAD (p < 0.0001). Change in height SDS was the only positive predictor of change in TBLH-BMC (r = 0.384, p = 0.037), and change in LS BMAD (r-0.934, p < 0.0001). Of 68 patients who had VFA, 4 (5.9%) had a mild vertebral fracture. Conclusion: Bones are smaller and less dense in childhood/adolescent AN compared to healthy adolescents. Although there are significant gains in lean mass and fat mass, over time, BMAD SDS decreases slightly. Improvement in BMAD SDS is related to improvement in height SDS.

Item Type:Articles
Keywords:Anorexia nervosa, anthropometrics, bone, height.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McDevitt, Dr Helen and Shaikh, Dr Mohammed Guftar and Ahmed, Professor Syed Faisal and Shepherd, Dr Sheila and Kyriakou, Dr Andreas and Mason, Dr Avril
Authors: Shepherd, S., Kyriakou, A., Shaikh, M. G., McDevitt, H., Oakley, C., Thrower, M., Ahmed, S. F., and Mason, A.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Bone
Publisher:Elsevier
ISSN:8756-3282
ISSN (Online):1873-2763
Published Online:27 March 2018
Copyright Holders:Copyright © 2018 Elsevier
First Published:First published in Bone 2018
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

University Staff: Request a correction | Enlighten Editors: Update this record