Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses

Osteopenia and osteoporosis are major complications of anorexia nervosa (AN). Since bone is a tissue requiring large amounts of energy, we examined the disproportionate increase in resting energy expenditure (REE) that occurs with refeeding of AN patients to determine if it was related to bone accre...

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Main Authors: Melissa Sum, Laurel Mayer, Michelle P. Warren
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Journal of Osteoporosis
Online Access:http://dx.doi.org/10.4061/2011/720328
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author Melissa Sum
Laurel Mayer
Michelle P. Warren
author_facet Melissa Sum
Laurel Mayer
Michelle P. Warren
author_sort Melissa Sum
collection DOAJ
description Osteopenia and osteoporosis are major complications of anorexia nervosa (AN). Since bone is a tissue requiring large amounts of energy, we examined the disproportionate increase in resting energy expenditure (REE) that occurs with refeeding of AN patients to determine if it was related to bone accretion. Thirty-seven AN patients aged 23.4 ± 4.8 years underwent a behavioral weight-gain protocol lasting a median of 66 days; 27 remained amenorrheic, and 10 regained menses. Sixteen controls aged 25.1 ± 4.7 years were age- and % IBW matched with patients. REE was measured using a respiratory chamber-indirect calorimeter. Significant correlations were found between REE and changes in spine (r=0.48, P<0.02) and leg (r=0.43, P<0.05) BMDs in AN patients. Further subgroup analysis of the amenorrheics revealed significant correlation between REE and change in spine BMD (r=0.59, P<0.02) and higher IGF-1 after weight gain compared to controls. Amenorrheics also had lower BMDs. These findings were absent in the regained menses group. The increase in REE seen in women with AN during nutritional rehabilitation may be related to active bone formation, which is not as prominent when menses have returned.
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spelling doaj-art-5d7bc57e9cdc40e18b1e460cf2cec5e12025-08-20T02:06:01ZengWileyJournal of Osteoporosis2042-00642011-01-01201110.4061/2011/720328720328Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of MensesMelissa Sum0Laurel Mayer1Michelle P. Warren2Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 16-128, New York, NY 10032, USAColumbia University College of Physicians and Surgeons, 622 West 168th Street, PH 16-128, New York, NY 10032, USAColumbia University College of Physicians and Surgeons, 622 West 168th Street, PH 16-128, New York, NY 10032, USAOsteopenia and osteoporosis are major complications of anorexia nervosa (AN). Since bone is a tissue requiring large amounts of energy, we examined the disproportionate increase in resting energy expenditure (REE) that occurs with refeeding of AN patients to determine if it was related to bone accretion. Thirty-seven AN patients aged 23.4 ± 4.8 years underwent a behavioral weight-gain protocol lasting a median of 66 days; 27 remained amenorrheic, and 10 regained menses. Sixteen controls aged 25.1 ± 4.7 years were age- and % IBW matched with patients. REE was measured using a respiratory chamber-indirect calorimeter. Significant correlations were found between REE and changes in spine (r=0.48, P<0.02) and leg (r=0.43, P<0.05) BMDs in AN patients. Further subgroup analysis of the amenorrheics revealed significant correlation between REE and change in spine BMD (r=0.59, P<0.02) and higher IGF-1 after weight gain compared to controls. Amenorrheics also had lower BMDs. These findings were absent in the regained menses group. The increase in REE seen in women with AN during nutritional rehabilitation may be related to active bone formation, which is not as prominent when menses have returned.http://dx.doi.org/10.4061/2011/720328
spellingShingle Melissa Sum
Laurel Mayer
Michelle P. Warren
Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses
Journal of Osteoporosis
title Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses
title_full Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses
title_fullStr Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses
title_full_unstemmed Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses
title_short Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses
title_sort bone mineral density accrual determines energy expenditure with refeeding in anorexia nervosa and supersedes return of menses
url http://dx.doi.org/10.4061/2011/720328
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