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Effects of the two types of anorexia nervosa (binge eating/purging and restrictive) on bone metabolism in female patients. | LitMetric

AI Article Synopsis

  • This study examines the differences between two types of anorexia nervosa: restrictive (AN-R) and binge eating/purging (AN-BP) in women, focusing on body composition, bone density, and hormonal interactions.
  • It involved 286 women with anorexia and 130 controls, measuring bone mineral density and energy expenditure, alongside markers of bone turnover.
  • While differences in bone status were noted, they largely vanished after adjusting for age and weight, highlighting that energy metabolism significantly influences bone health in anorexia patients.

Article Abstract

Objective: This study compared the profiles of the two types of anorexia nervosa (AN; restrictive: AN-R, and binge eating/purging: AN-BP) in terms of body composition, gynaecological status, disease history and the potential effects on bone metabolism.

Design: Two hundred and eighty-six women with AN (21.8 ± 6.5 years; 204 AN-R and 82 AN-BP) and 130 age-matched controls (CON; 22.6 ± 6.8 years) were enrolled. Areal bone mineral density (aBMD) was determined using DXA and resting energy expenditure (REE) was indirectly assessed using calorimetry. Markers of bone formation (osteocalcin [OC], procollagen type I N-terminal propeptide [PINP] and resorption (type I-C telopeptide breakdown products [CTX]) and leptin were concomitantly evaluated.

Results: Anorexia nervosa patients presented an alteration in aBMD and bone turnover. When compared according to type, AN-BP were older than AN-R and showed less severe undernutrition, lower CTx levels, longer duration of AN, and higher REE levels and aBMD at radius and lumbar spine. After adjustment for age, weight and hormonal contraceptive use, the aBMD and CTx differences disappeared. In both AN groups, aBMD was positively correlated with anthropometric parameters and negatively correlated with durations of AN and amenorrhoea, the bone formation markers (OC and PINP) and the leptin/fat mass ratio. REE was positively correlated with aBMD in AN-R patients only.

Conclusions: This study shows the profiles of AN patients according to AN type. However, the impact of the profile characteristics on bone status, although significant, was minor and disappeared after multiple adjustments. The positive correlation between REE and aBMD reinforces the concept that energy disposal and bone metabolism are strongly interdependent.

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Source
http://dx.doi.org/10.1111/cen.13610DOI Listing

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