This Article Full Text Full Text (PDF) All Versions of this Article: 92/6/2046    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Misra, M. Articles by Klibanski, A. Search for Related Content PubMed PubMed Citation Articles by Misra, M. Articles by Klibanski, A. Related Collections Calcium and Bone Metabolism Metabolism Neuroendocrinology and Pituitary

Relationships between Serum Adipokines, Insulin Levels, and Bone Density in Girls with Anorexia Nervosa

Neuroendocrine Unit (M.M., K.K.M., J.C., R.P., A.K.), Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114; Harris Center (D.B.H.), Massachusetts General Hospital, Boston, Massachusetts 02114; Division of Adolescent Medicine (M.G.), MassGeneral Hospital for Children and Harvard Medical School, Boston, Massachusetts 02114; and Division of Adolescent Medicine (D.K.K.), Department of Pediatrics, Hospital for Sick Kids, Toronto, Canada M5G 1X8

Address all correspondence and requests for reprints to: Madhusmita Misra, M.D., BUL 457, Neuroendocrine Unit, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114. E-mail: mmisra{at}partners.org.

Background: Adolescents with anorexia nervosa (AN) have low bone mineral density (BMD). Adipokines and insulin play an important role in bone metabolism in healthy individuals. However, their association with bone metabolism in AN is unknown.

Objective: The aim of the study was to determine whether adipokines and insulin are independently associated with measures of BMD in adolescents with AN and controls.

Design/Methods: Levels of adiponectin and insulin, fasting and after oral glucose, were evaluated in 17 AN patients and 19 controls (age, 12–18 yr), in whom hormonal parameters [GH, IGF-I, cortisol, estradiol, leptin, ghrelin, and peptide YY (PYY)] had been previously determined. Body composition, bone mineral content, and BMD at the lumbar spine, hip, femoral neck, and total body were assessed by dual energy x-ray absorptiometry. Two bone formation and bone resorption markers were examined.

Setting: The study was conducted at a General Clinical Research Center.

Results: Adiponectin differed between AN subjects and controls after controlling for fat mass and decreased in both after oral glucose (P = 0.02 and 0.07). On regression modeling, independent associations were observed of: 1) body mass index and adiponectin with lumbar spine bone mineral apparent density Z-scores (r² = 0.45); 2) lean mass, PYY, and ghrelin with hip Z-scores (r² = 0.55); 3) adiponectin and lean mass with femoral neck-bone mineral apparent density Z-scores (r² = 0.34); and 4) lean mass, PYY, GH, and ghrelin with total body-bone mineral content/height Z-scores (r² = 0.64), for the combined group. Adiponectin was also independently associated with BMD, and insulin was associated with bone turnover markers in the groups considered separately.

Conclusions: Adiponectin contributes significantly to the variability of bone density, and insulin contributes to bone turnover markers in adolescent girls.

This article has been cited by other articles:

				M. Misra, R. Prabhakaran, K. K. Miller, M. A. Goldstein, D. Mickley, L. Clauss, P. Lockhart, J. Cord, D. B. Herzog, D. K. Katzman, et al. Prognostic Indicators of Changes in Bone Density Measures in Adolescent Girls with Anorexia Nervosa-II J. Clin. Endocrinol. Metab., April 1, 2008; 93(4): 1292 - 1297. [Abstract] [Full Text] [PDF]