Advertisement

Wiener Medizinische Wochenschrift

, Volume 157, Issue 23–24, pp 582–588 | Cite as

Bone turnover in nutrition-related disorders

  • Markus J. Seibel
Themenschwerpunkt

Summary

It has been known for some time that nutritional and lifestyle factors are of great importance in the development and maintenance of normal bone mass and remodelling. Recent studies suggest that hypovitaminosis D is frequent in children and adolescent persons, and may affect their bone health. Clearly, chronic eating disorders such as anorexia nervosa are associated with high rates of bone resorption and bone loss, and increased fracture risk. In obese patients weight loss is associated with changes in both bone mineral density and bone remodelling, although the pathogenesis of these changes is ill defined. Biochemical markers of bone remodelling are non-invasive and comparatively inexpensive tools to evaluate the two major processes of bone renewal: bone formation and bone resorption. Over the past 15 years, research has generated a number of novel and specific bone markers that enable us to investigate those processes even more closely.

Keywords

Bone mass Bone remodelling Malnutrition Nutrition Obesity Weight loss 

Abbreviations

ALP

alkaline phosphatase

BALP

bone specific alkaline phosphatase

BMD

bone mineral density

BMI

body mass index

CTX-I

carboxyl-terminal telopeptide of collagen type I

GFD

gluten-free diet

NTX-I

amino-terminal telopeptide of collagen type I

PTH

parathyroid hormone

TRACP

tartrate-resistant acid phosphatase

Knochenstoffwechsel bei ernährungsbedingten Erkrankungen

Zusammenfassung

Seit einiger Zeit ist bekannt, dass die Ernährung und der Lebensstil für die Entwicklung und Erhaltung einer normalen Knochendichte und eines normalen Knochenumbaus von großer Bedeutung sind. Neue Studien legen nahe, dass die Hypovitaminose D bei Kindern und Adoleszenten häufig ist und ihre Knochengesundheit beeinflussen kann. Chronische Essstörungen wie Anorexia nervosa sind mit einer gesteigerten Knochenresorption, Knochendichteverlust und einem erhöhten Frakturrisiko assoziiert. Obwohl die Pathogenese dieser Veränderungen noch unklar ist, finden sich auch bei übergewichtigen Patienten Veränderungen der Knochendichte und des Knochenumsatzes. Biochemische Marker des Knochenumsatzes stellen eine nicht-invasive und eine vergleichsweise günstige Methode zur Evaluierung der zwei wesentlichsten Vorgänge des Knochenumbaus, der Knochenneubildung und der Knochenresorption, dar. In den letzen 15 Jahren hat die Forschung eine Anzahl von neuen und spezifischen Knochenmarkern zur genauen Untersuchung dieser Prozesse hervorgebracht.

Schlüsselwörter

Knochendichte Knochenumbau Mangelernährung Ernährung Übergewicht Gewichtsverlust 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Seibel MJ (2005) Biochemical markers of bone turnover: part I: biochemistry and variability. Clin Biochem Rev 26: 97–122PubMedPubMedCentralGoogle Scholar
  2. Seibel MJ (2006) Biochemical markers of bone turnover: part II: clinical applications in the management of osteoporosis. Clin Biochem Rev 27: 123–138PubMedPubMedCentralGoogle Scholar
  3. Bonofiglio D, Maggiolini M, Catalano S, Marsico S, Aquila S, Ando S (2001) Bone mineral density is inversely related to parathyroid hormone in adolescent girls. Horm Metab Res 33: 170–174CrossRefPubMedGoogle Scholar
  4. Carter LM, Whiting SJ, Drinkwater DT, Zello GA, Faulkner RA, Bailey DA (2001) Self-reported calcium intake and bone mineral content in children and adolescents. J Am Coll Nutr 20: 502–509CrossRefPubMedGoogle Scholar
  5. Rauch R, Schönau E, Woitge H, Remer T, Seibel M (1994) Excretion of urinary hydroxy-pyridinium crosslinks of collagen reflects skeletal growth velocity in normal children. Exp Clin Endocrinol 102: 94–97CrossRefPubMedGoogle Scholar
  6. Outila TA, Karkkainen MU, Lamberg-Allardt CJ (2001) Vitamin D status affects serum parathyroid hormone concentrations during winter in female adolescents: associations with forearm bone mineral density. Am J Clin Nutr 74: 206–210PubMedGoogle Scholar
  7. Mishal AA (2001) Effects of different dress styles on vitamin D levels in healthy young Jordanian women. Osteoporos Int 12: 931–935CrossRefPubMedGoogle Scholar
  8. El-Hajj Fuleihan G, Nabulsi M, Choucair M, Salamoun M, Haji Shahine C, Kizirian A, Tannous R (2001) Hypovitaminosis D in healthy school-children. Pediatrics [online serial] 107: E53. http://www.pediatrics.org/cgi/content/full/107/4/e53 Google Scholar
  9. Klein GL, Langman CB, Herndon DN (2002) Vitamin D depletion following burn injury in children: a possible factor in post-burn osteopenia. J Trauma 52: 346–350CrossRefPubMedGoogle Scholar
  10. Mora S, Barera G, Beccio S, Menni L, Proverbio MC, Bianchi C, Chiumello G (2001) A prospective, longitudinal study of the long-term effect of treatment on bone density in children with celiac disease. J Pediatr 139: 516–521CrossRefPubMedGoogle Scholar
  11. Parsons TJ, van Dusseldorp M, Seibel MJ, van Staveren WA (2001) Are levels of bone turnover related to lower bone mass of adolescents previously fed a macrobiotic diet? Exp Clin Endocrinol Diabetes 109: 288–293CrossRefPubMedGoogle Scholar
  12. Turner JM, Bulsara MK, McDermott BM, Byrne GC, Prince RL, Forbes DA (2001) Predictors of low bone density in young adolescent females with anorexia nervosa and other dieting disorders. Int J Eat Disord 30: 245–251CrossRefPubMedGoogle Scholar
  13. Zipfel S, Specht T, Herzog W (1998) Medical complications in eating disorders. In: Hoeck H, Treasure J, Katzman M (eds) The integration of neurobiology in the treatment of eating disorders. Wiley and Sons, New York, pp 457–484Google Scholar
  14. Herzog W, Minne H, Deter C, Leidig G, Schellberg D, Wüster C, Gronwald R, Sarembe E, Kröger F, Bergmann G (1993) Outcome of bone mineral density in anorexia nervosa patients 11.7 years after first admission. J Bone Miner Res 8: 597–605CrossRefPubMedGoogle Scholar
  15. Biller BM, Saxe V, Herzog DB, Rosenthal DI, Holzman S, Klibanski A (1989) Mechanisms of osteoporosis in adult and adolescent women with anorexia nervosa. J Clin Endocrinol Metab 68: 548–554CrossRefPubMedGoogle Scholar
  16. Zipfel S, Seibel MJ, Lowe B, Beumont PJ, Kasperk C, Herzog W (2001) Osteoporosis in eating disorders: a follow-up study of patients with anorexia and bulimia nervosa. J Clin Endocrinol Metab 86: 5227–5233CrossRefPubMedGoogle Scholar
  17. Hotta M, Fukuda I, Sato K, Hizuka N, Shibasaki T, Takano K (2000) The relationship between bone turnover and body weight, serum insulin-like growth factor (IGF) I, and serum IGF-binding protein levels in patients with anorexia nervosa. J Clin Endocrinol Metab 85: 200–206PubMedGoogle Scholar
  18. Caillot-Augusseau A, Lafage-Proust MH, Margaillan P, Vergely N, Faure S, Paillet S, Lang F, Alexandre C, Estrour B (2000) Weight gain reverses bone turnover and restores circadian variation of bone resorption in anorexic patients. Clin Endocrinol (Oxf) 52: 113–121CrossRefGoogle Scholar
  19. Ricci TA, Heymsfield SB, Pierson RN Jr, Stahl T, Chowdhury HA, Shapses SA (2001) Moderate energy restriction increases bone resorption in obese postmenopausal women. Am J Clin Nutr 73: 347–352PubMedGoogle Scholar
  20. Shapses SA, Von Thun NL, Heymsfield SB, Ricci TA, Ospina M, Pierson RN Jr, Stahl T (2001) Bone turnover and density in obese premenopausal women during moderate weight loss and calcium supplementation. J Bone Miner Res 16: 1329–1336CrossRefPubMedGoogle Scholar
  21. Jensen LB, Kollerup G, Quaade F, Sorensen OH (2001) Bone minerals changes in obese women during a moderate weight loss with and without calcium supplementation. J Bone Miner Res 16: 141–147CrossRefPubMedGoogle Scholar
  22. McLean JA, Barr SI, Prior JC (2001) Cognitive dietary restraint is associated with higher urinary cortisol excretion in healthy premenopausal women. Am J Clin Nutr 73: 7–12PubMedGoogle Scholar
  23. Pace DG, Blotner S, Guerciolini R (2001) Short-term orlistat treatment does not affect mineral balance and bone turnover in obese men. J Nutr 131: 1694–1699PubMedGoogle Scholar
  24. Black A, Allison DB, Shapses SA, Tilmont EM, Handy AM, Ingram DK, Roth GS, Lane MA (2001) Calorie restriction and skeletal mass in rhesus monkeys (Macaca mulatta): evidence for an effect mediated through changes in body size. J Gerontol A Biol Sci Med Sci 56: B98–B107CrossRefPubMedGoogle Scholar
  25. Meier C, Woitge HW, Witte K, Lemmer B, Seibel MJ (2004) Supplementation with oral vitamin d3 and calcium during winter prevents seasonal bone loss: a randomized controlled open-label prospective trial. J Bone Miner Res 19: 1221–1230CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  1. 1.ANZAC Research Institute and Department of Endocrinology & Metabolism, Concord Hospital Medical CentreThe University of SydneySydneyAustralia

Personalised recommendations