Modestly degraded microarchitecture and high serum levels of osteopontin in Swedish females with anorexia nervosa
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ORIGINAL ARTICLE
Modestly degraded microarchitecture and high serum levels of osteopontin in Swedish females with anorexia nervosa Pär Wanby1,2,3 · Lars Brudin4,5 · Siv‑Ping Von6 · Martin Carlsson6,7 Received: 2 July 2020 / Accepted: 22 October 2020 © The Author(s) 2020
Abstract 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. Keywords Anorexia nervosa · Microarchitecture · TBS · Osteopontin · Dkk-1
Introduction Anorexia nervosa (AN) is characterized by low-fat mass, often complicated by reduction of bone mass, impaired bone structure, and fractures [1]. As an adaptation to chronic
undernutrition, multiple endocrine abnormalities develop with a profound impact on bone metabolism, and a compromised bone mineral density (BMD) is a hallmark of AN [2]. Adult women with long-term AN [3] are believed to have osteopenia (T-score ≤ 1.0) in 93 % and osteoporosis (T-score
* Pär Wanby [email protected]
3
Department of Internal Medicine, Section of Endocrinology, Region Kalmar County, 392 44 Kalmar, Sweden
Lars Brudin [email protected]
4
Department of Medical and Health Sciences, University of Linköping, SE, 581 83 Linköping, Sweden
Siv‑Ping Von [email protected]
5
Department of Clinical Physiology, Region Kalmar County, SE, 392 44 Kalmar, Sweden
Martin Carlsson [email protected]
6
Department of Clinical Chemistry, Region Kalmar County, SE, 392 44 Kalmar, Sweden
7
Department of Medicine and Optometry, Linnaeus Uni
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