Anorexia nervosa (AN) is associated with bone loss due to weight loss, decreased caloric intake, amenorrhoea and behavioral changes. The most important predictor of the occurrence of bone loss is body weight (BMI <16.5 kg/m2). Previous studies suggested that many factors including effects of chronic undernutrition in AN patients is associated with a reduction of bone formation (osteocalcin-OC) uncoupled with increased resorption markers (crosslaps-CTx). The aim of the study was to investigate the relationship of bone turnover and body weight and serum leptin levels in 13 AN patients (BMI 14.3±0.4 kg/m2; DSM-IV criteria). They were compared with 9 age matched lean controls (BMI 20.1±0.8 kg/m2; CO). After overnight fast serum leptin, osteocalcin-OCL, CTx and 25-OH-vitamin D levels were measured. Bone mineral density (BMD) were estimated by DEXA (Hologic). Relevant parameters are presented as mean±S.E.M. in Table.
|Gr||Age (years)||BMI (kg/m2)||Leptin (ng/ml)||OCL (ng/ml)||CTx (ng/ml)||Vit. D (nmol/l)||DEXA Z score|
Conclusion: Our results favour the role of body weight, fat mass and leptin in uncoupling of bone turnover with decreased bone formation and increased bone resorption in women with AN leading to decrease in bone mass. The precise mechanism for enhanced bone resorbtion in AN is unclear but is tempting to speculate that leptin might inhibit it.
03 - 07 May 2008
European Society of Endocrinology