Reduced Bone Strength and Muscle Force in Women 27 Years After Anorexia Nervosa.

J Clin Endocrinol Metab

Exercise Physiology (S.M.M., E.A., U.B., M.T.), Institute of Human Movement Sciences, ETH Zurich, CH-8057 Zurich, Switzerland; Statewide Mental Health Program (M.I.), Elk Grove, California 95758; Department of Psychology (S.D.), Division of Clinical Psychology and Psychotherapy, University of Zurich, CH-8050 Zurich, Switzerland; and Laboratory for Muscle Plasticity (M.T.), Balgrist University Hospital, Department of Orthopedics, University of Zurich, CH-8008 Zurich, Switzerland.

Published: August 2015

Context: A substantial body of research findings indicate that muscle mass and bone mass are reduced in populations of anorexic females, even in such populations whose anorexia nervosa had been in remission for longer periods.

Objective: This study aimed to investigate whether the bone of an anorexia nervosa recovery cohort is adapted to maximal muscle forces and whether there are alterations in the structure of the tibia in this population, as compared with a control group.

Design, Setting, And Participants: This was a cross-sectional study of 22 women in Switzerland who have remained in stable recovery from anorexia nervosa for an average of 27 years. The measurements were compared with those of an age- and gender-matched control group (n = 73).

Interventions: There were no interventions.

Main Outcome Measures: Bone characteristics of the tibia and maximal voluntary ground reaction force (Fm1LH) were measured.

Results: The variability in volumetric bone mineral content (vBMC) at the 14% site was explained by 54.7% on the grounds of Fm1LH (P < .001). Formerly anorexic women had an 11.6% lower Fm1LH (P = .001), a significantly lower vBMC at 4% and 14% of tibia length, and an 11.9% (P = .001) lower body mass than the age- and gender-matched control population. Present body mass of the anorexia group correlated positively with vBMC at the 14% site (P < .001).

Conclusions: Despite the fact that findings reflected an adaptation of bone to the acting forces, most results indicated that the test cohort generally suffered from a secondary bone defect. In addition, maximal muscle force was also impaired in the formerly anorexic women.

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http://dx.doi.org/10.1210/jc.2015-1011DOI Listing

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