Abstract
Objective: Anorexia nervosa (anorexia nervosa, AN) significantly affects the bone health. The aim of our study was to evaluate the parameters of bone metabolism in a group of Czech girls with AN.
Patients and methods: The group included 32 girls with AN. Bone Mineral Density (BMD) of the lumbar spine, hip area, hormonal profile (LH, estradiol), and bone turnover parameters (osteocalcin, P1NP, beta-CTx) were examined.
Results: The group included 32 girls with an average age of 15.2 years (range 11-17 years), the disease duration of 8.7 months (range 3-24 months), an average weight loss of 12 kg (2-36 kg). The mean Z-score in the lumbar spine was 0.08+-1.40, in the hip 0.23+-1.28, and the overall Z-score was 0.13+-1.14.
When comparing the group of girls with primary amenorrhea or girls with secondary amenorrhea lasting 0-5 months and the group of girls with amenorrhea lasting 6 months and longer, a statistically insignificant decrease in the lumbar spine, hip and combined BMD was observed. Laboratory examination of bone turnover showed a reduction in osteocalcin (81.8% 97. p.) was increased, according to normal ranges for the given age.
Both estradiol and LH levels were reduced (53.1% <18.4 pmol/l; and 50% <0.1 U/l, respectively). In girls with the lowest plasma estradiol concentrations (<18.4 pmol/l), statistically significantly lower absolute hip BMD values were found p=0.009.
Conclusion: The results of the study show that hormonal changes precede changes in bone metabolism, which may later manifest at the level of morphologically measurable.