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Anorexia nervosa, osteoporosis and circulating leptin: the missing link

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Abstract

Summary

Methods: Leptin levels were measured in 103 consecutive women with anorexia nervosa. Results: Spine BMD and Z-score values were found to be significantly lower in the low tertile compared with the highest tertile. Duration of amenorrhea and leptin level accounted for 27% of the variance in lumbar spine BMD.

Introduction

The purpose of this study was to assess leptin levels and other biological variables in a population of anorexia nervosa patients.

Methods

Leptin levels were measured consecutively in 103 women with anorexia nervosa (AN) with a mean age of 24.9 ± 7.4 years. Osteodensitometry was also performed by dual energy X-ray absorptiometry (DXA).

Results

Spine bone mineral density (BMD) and Z-score values were found to be significantly lower in the low tertile compared with the highest tertile. Duration of amenorrhea and leptin level accounted for 27% of the variance in lumbar spine BMD. The mean leptin level was 3.9 ± 4.6 ng/mL (normal values, 3.5-11 ng/mL). The distribution of leptin values was not a Gaussian distribution, and a log-transformed was therefore performed. A significant correlation was found between leptin level and spinal BMD (r = 0.3; p = 0.002); significant correlations were observed for both femoral neck and total hip BMDs. When leptin level values were divided into tertiles, spine BMD and Z-score values were found to be significantly lower in the lower tertile (p = 0.04 and p = 0.02) compared with the highest tertile. For femoral neck BMDs, the T-score was slightly lower between low and high tertile, but the difference was not statistically significant (p = 0.07). When multivariate analyses were performed, two independent factors which could possibly account for the variance in spinal BMDs were found. Duration of amenorrhea and leptin level accounted for 27% of the variance (p < 0.0001).

Conclusion

The mechanisms underlying bone loss in AN patients remain unclear and complex, involving hypoestrogenia as well as nutritional factors such as insulin-like growth factor and leptin.

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Correspondence to I. Legroux-Gérot.

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B. Duquesnoy passed away after the submission of this article.

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Legroux-Gérot, I., Vignau, J., Biver, E. et al. Anorexia nervosa, osteoporosis and circulating leptin: the missing link. Osteoporos Int 21, 1715–1722 (2010). https://doi.org/10.1007/s00198-009-1120-x

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  • DOI: https://doi.org/10.1007/s00198-009-1120-x

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