Bone metabolism in anorexia nervosa: molecular pathways and current treatment modalities.
Howgate DJ, et al.
Osteoporos Int. 2012 Aug 9.
Eating disorders are associated with a multitude of metabolic abnormalities which are known to adversely affect bone metabolism and structure. We aimed to comprehensively review the literature on the effects of eating disorders, particularly anorexia nervosa (AN), on bone metabolism, bone mineral density (BMD), and fracture incidence. Furthermore, we aimed to highlight the risk factors and potential management strategies for patients with eating disorders and low BMD. We searched the MEDLINE/OVID (1950-July 2011) and EMBASE (1980-July 2011) databases, focussing on in vitro and in vivo studies of the effects of eating disorders on bone metabolism, bone mineral density, and fracture incidence. Low levels of estrogen, testosterone, dehydroepiandrosterone, insulin-like growth factor-1 (IGF-1), and leptin, and high levels of cortisol, ghrelin, and peptide YY (PYY) are thought to contribute to the ‘uncoupling’ of bone turnover in patients with active AN, leading to increased bone resorption in comparison to bone formation. Over time, this results in a high prevalence and profound degree of site-specific BMD loss in women with AN, thereby increasing fracture risk. Weight recovery and increasing BMI positively correlate with levels of IGF-1 and leptin, normalisation in the levels of cortisol, as well as markers of bone formation and resorption in both adolescent and adult patients with AN. The only treatments which have shown promise in reversing the BMD loss associated with AN include: physiologic dose transdermal and oral estrogen, recombinant human IGF-1 alone or in combination with the oral contraceptive pill, and bisphosphonate therapy.
Source: Academic Department of Orthopaedics and Trauma, Salford Royal University Teaching Hospital, Salford Royal NHS Foundation Trust, Stott Lane, M6 8HD, Salford, UK.
PICKY EATERS CLINIC Klinik Khusus Kesulitan Makan Pada Anak dan GROW UP CLINIC Klinik Khusus Gangguan Pertumbuhan Berat Badan Anak Yudhasmara Foundation www.pickyeaterschild.wordpress.com/ email : email@example.com
WORKING TOGETHER FOR STRONGER, HEALTHIER AND SMARTER CHILDREN BY EDUCATION, CLINICAL INTERVENTION, RESEARCH AND NETWORKING INFORMATION. Advancing of the future pediatric and future parenting to optimalized physical, mental and social health and well being for fetal, newborn, infant, children, adolescents and young adult
CHILDREN GROW UP CLINIC I
- CHILDREN GROW UP CLINIC I, JL Taman Bendungan Asahan 5 Bendungan Hilir Jakarta Pusat 10210 Phone : 5703646 – 44466102
- CHILDREN GROW UP CLINIC II, MENTENG SQUARE Jl Matraman 30 Jakarta Pusat 10430 Phone 44466103 – 97730777
|LAYANAN KLINIK KHUSUS “CHILDREN GRoW UP CLINIC”
PROFESIONAL MEDIS “CHILDREN GRoW UP CLINIC”
Clinical – Editor in Chief :
Dr WIDODO JUDARWANTO, pediatrician
- email : firstname.lastname@example.org
- curriculum vitae
- For Daily Newsletter join with this Twitter https://twitter.com/WidoJudarwanto
Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should carefully read all product packaging. If you have or suspect you have a medical problem, promptly contact your professional healthcare provider
Copyright © 2012, Picky Eaters and Grow Up Clinic, Information Education Network. All rights reserved