Modestly degraded microarchitecture and high serum levels of osteopontin in Swedish females with anorexia nervosa.
PURPOSE
Adult women with long-time anorexia nervosa (AN) are believed to have osteopenia (T-score ≤ 1.0) in 93 % and osteoporosis (T-score ≤ 2.5) in 38 %. Bone microarchitecture assessed by Trabecular Bone Score (TBS) predicts osteoporotic fractures. Our aim was to evaluate the microarchitecture in adult females with AN by determining TBS and to identify factors potentially associated with TBS, such as bone turnover markers.


METHODS
20 female patients with AN (DSM IV), aged 27.8 ± 4.4 years, BMI 16.6 ± 0.6 kg/m2 and duration of illness of 8.5 ± 5 years had previously been evaluated with dual-energy X-ray absorptiometry (DXA). TBS measurements were now obtained, using iNsight software, from spinal DXA images. Serum levels of bone turnover markers were determined in patients and healthy normal-weight controls.


RESULTS
Compared to controls serum values of osteopontin were higher (p = 0.009). BMD in patients with AN was reduced by at least 1.0 SD at one or more skeletal sites in 65 % of patients and by at least 2.5 SD in 20 %. Only one of the patients (5%) had suffered a fracture. TBS (mean 1.35 ± 0.06; median 1.36 (1.23-1.44) was in the lower normal range (≥ 1.35). 40 % of patients showed partially (> 1.20 and < 1.35) but none showed a fully degraded micro-architecture.


CONCLUSIONS
In Swedish AN patients we found a low reduction of BMD and fracture history. The bone microarchitecture, evaluated for the first time for this group by TBS, was only modestly compromised, and to a lesser extent than expected for this group of patients with AN.


LEVEL OF EVIDENCE
Level V; cross-sectional descriptive study.
['Wanby|Pär|P|http://orcid.org/0000-0001-8538-6800', 'Brudin|Lars|L|', 'Von|Siv-Ping|SP|', 'Carlsson|Martin|M|']
D015502:Absorptiometry, Photon D000328:Adult D000856:Anorexia Nervosa D015519:Bone Density D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008159:Lumbar Vertebrae D053495:Osteopontin D058866:Osteoporotic Fractures D013548:Sweden
Microarchitecture Osteopontin Anorexia nervosa TBS Dkk-1