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Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy

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Abstract

Purpose

Anorexia nervosa (AN) is associated with reduced bone mass and an increased fracture risk. The aim was to evaluate the vitamin D status and the association with body mass index (BMI), fat mass and bone mineral density (BMD) in patients with severe AN during a prospective intervention study of intensive nutrition therapy.

Methods

This study comprised 25 Swedish female AN patients (20.1 ± 2.3 years), who were treated as inpatients for 12 weeks with a high-energy diet. Serum 25-hydroxyvitamin D (25(OH)D), calcium, phosphate and parathyroid hormone (PTH) were measured. BMD and body composition were assessed by dual-energy X-ray absorptiometry at study start and after 12 weeks.

Results

Twenty-two patients completed the study. The mean weight gain was 9.9 kg and BMI (mean ± SD) increased from 15.5 ± 0.9 to 19.0 ± 0.9 kg/m2, P < 0.0001. Fat mass increased from median 12 to 27 %. The median serum 25(OH)D level was 84 nmol/L at baseline, which decreased to 76 nmol/L, P < 0.05. PTH increased from median 21.9 to 30.0 ng/L, P < 0.0001. BMC increased during the study period, P < 0.001.

Conclusions

Serum 25(OH)D levels were adequate both at study start and completion, however, nominally decreased after the 12-week nutritional intervention. PTH increased subsequently, which coincide with the decreased 25(OH)D levels. The reduction in 25(OH)D could be due to an increased storage of vitamin D related to the increase in fat mass since vitamin D is sequestered in adipose tissue.

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Acknowledgments

We thank the participating adolescents for their enthusiasm and patience, and we also thank the staff at the Anorexia ward at the Queen Silvia Children’s Hospital. We acknowledge the expert assistance of Anne Dohsé and Ewa Lönn Karlsson. We would like to thank Aldina Pivodic and Mattias Molin for their expert statistical advice. All authors take full responsibility for the manuscript and have read and approved the final version for submission. The study was also made possible by grants from the Queen Silvia Children´s Hospital Research Foundation, The Capio Foundation, The Samariten Foundation, Region Östergötland, Sahlgrenska University Hospital and the Health & Medical Care Committee of the Regional Executive Board Region Västra Götaland and from Governmental University Hospital (ALF).

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Authors and Affiliations

  1. Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children’s Hospital, Sahlgrenska Academy, Gothenburg University, Rondvägen 15, SE-416 85, Göteborg, Sweden

    Anna Svedlund, Bojan Tubic & Diana Swolin-Eide

  2. Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, Gothenburg University, Göteborg, Sweden

    Cecilia Pettersson

  3. Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden

    Per Magnusson

Authors
  1. Anna Svedlund
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  2. Cecilia Pettersson
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  3. Bojan Tubic
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  4. Per Magnusson
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  5. Diana Swolin-Eide
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Correspondence to Anna Svedlund.

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Svedlund, A., Pettersson, C., Tubic, B. et al. Vitamin D status in young Swedish women with anorexia nervosa during intensive weight gain therapy. Eur J Nutr 56, 2061–2067 (2017). https://doi.org/10.1007/s00394-016-1244-7

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  • DOI: https://doi.org/10.1007/s00394-016-1244-7

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