ARTICLE
Bone mineralization and densitometric evaluation of vertebral fractures in women 6–21 years after the onset of anorexia nervosa symptoms
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1
Klinika Psychiatrii Wieku Rozwojowego, Warszawski Uniwersytet Medyczny
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Katedra i Klinika Nefrologii, Dializoterapii i Chorób Wewnętrznych, Warszawski Uniwersytet Medyczny
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Katedra i Klinika Chorób Wewnętrznych i Endokrynologii, Warszawski Uniwersytet Medyczny
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Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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II Zakład Radiologii Klinicznej, Warszawski Uniwersytet Medyczny
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Zakład Radiologii Pediatrycznej, Warszawski Uniwersytet Medyczny
Submission date: 2016-02-22
Final revision date: 2016-05-08
Acceptance date: 2016-05-13
Online publication date: 2017-04-30
Publication date: 2017-04-30
Corresponding author
Gabriela Jagielska
Klinika Psychiatrii Wieku Rozwojowego, Warszawski Uniwersytet Medyczny, Marszałkowska 24, 00-576 Warszawa, Polska
Psychiatr Pol 2017;51(2):231-246
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ABSTRACT
Objectives:
We attempted to assess bone mineralization and the frequency of fractures occurrence in women with a history of treatment of anorexia nervosa (AN) in adolescence.
Methods:
47 women (age 20–36.8 years) were re-examined 6.33–21,2 years after the onset of AN symptoms. Bone mineral density (BMD) of total body, lumbar spine, femoral neck, total hip (DXA) and densitometric Vertebral Fracture Assessment (VFA) were performed on 46 of women and BAP, P1NP, CTX, estradiol, testosterone, cortisol, IGF-1, leptin, DHEA-S on 45 of women entered for the current study. Current BMD results were compared with available baseline results from the time of hospitalization.
Results:
Currently BMD Z-score <-1 examined at any location occurred in 28 from 46 women (including Z-score <-2 in 5 women). In 11 from 12 women with reduced BMD at the time of hospitalization current total body BMD was within the normal range. Lumbar spine BMD was normalized or improved respectively in 5 and 6 from 15 women. Currently increased levels/activity of bone formation markers: P1NP in 27 (60%) and BAP in 28 women (62.2%) were observed. In 7 women (15.6%) increased values of bone formation markers with increased marker of bone resorption (CTX) occurred. Osteoporotic fractures and fractures in the spine in VFA were not observed during the observation period.
Conclusions:
Despite early treatment of adolescent-onset AN and good outcomes of the treatment, decreased BMD was currently present in 60.9% of women. During follow-up normalization or significant improvement in BMD results (total body, lumbar spine) were observed in majority of cases.