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Anorexia nervosa and osteoporosis

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Abstract

Anorexia nervosa (AN), a condition of severe undernutrition, is associated with low bone mineral density (BMD) in adults and adolescents. Whereas adult women with AN have an uncoupling of bone turnover markers with increased bone resorption and decreased bone formation markers, adolescents with AN have decreased bone turnover overall. Possible contributors to low BMD in AN include hypoestrogenism and hypoandrogenism, undernutrition with decreased lean body mass, and hypercortisolemia. IGF-I, a known bone trophic factor, is reduced despite elevated growth hormone (GH) levels, leading to an acquired GH resistant state. Elevated ghrelin and peptide YY levels may also contribute to impaired bone metabolism. Weight recovery is associated with recovery of BMD but this is often partial, and long-term and sustained weight recovery may be necessary before significant improvements are observed. Anti-resorptive therapies have been studied in AN with conflicting results. Oral estrogen does not increase BMD or prevent bone loss in AN. The combination of bone anabolic and anti-resorptive therapy (rhIGF-I with oral estrogen), however, did result in a significant increase in BMD in a study of adult women with AN. A better understanding of the pathophysiology of low BMD in AN, and development of effective therapeutic strategies is critical. This is particularly so for adolescents, who are in the process of accruing peak bone mass, and in whom a failure to attain peak bone mass may occur in AN in addition to loss of established bone.

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References

  1. Lucas AR, Beard CM, O’Fallon WM, Kurland LT. 50-year trends in the incidence of anorexia nervosa in Rochester, MN: a population-based study. Am J Psychiatry 1991;148:917–22

    PubMed  CAS  Google Scholar 

  2. Von Ranson K, Iacono W, McGue M. Disordered eating and substance abuse in an epidemiological sample. 1. Associations within individuals. Int J Eat Disord 2002;31:389–403

    Article  Google Scholar 

  3. Andersen A, Woodward P, LaFrance N. Bone mineral density of eating disorder subgroups. Int J Eat Disord 1995;18:335–42

    Article  PubMed  CAS  Google Scholar 

  4. Hay P, Delahunt J, Hall A, Mitchell A, Harper G, Salmond C. Predictors of osteopenia in premenopausal women with anorexia nervosa. Calcif Tissue Int 1992;50:498–501

    Article  PubMed  CAS  Google Scholar 

  5. Rigotti N, Neer R, Skates S, Herzog D, Nussbaum S. The clinical course of osteoporosis in anorexia nervosa. A longitudinal study of cortical bone mass. JAMA 1991;265:1133–8

    Article  PubMed  CAS  Google Scholar 

  6. Bolton J, Patel S, Lacey J, White S. A prospective study of changes in bone turnover and bone density associated with regaining weight in women with anorexia nervosa. Osteoporos Int 2005;16:1955–62

    Article  PubMed  Google Scholar 

  7. Lennkh C, de Zwaan M, Bailer U, Strnad A, Nagy C, El-Giamal N, et al. Osteopenia in anorexia nervosa: specific mechanisms of bone loss. J Psychiatr Res 1999;33:349–56

    Article  PubMed  CAS  Google Scholar 

  8. Grinspoon S, Miller K, Coyle C, Krempin J, Armstrong C, Pitts S, et al. Severity of osteopenia in estrogen-deficient women with anorexia nervosa and hypothalamic amenorrhea. J Clin Endocrinol Metab 1999;84:2049–55

    Article  PubMed  CAS  Google Scholar 

  9. Bachrach L, Guido D, Katzman D, Litt I, Marcus R. Decreased bone density in adolescent girls with anorexia nervosa. Pediatrics 1990;86:440–7

    PubMed  CAS  Google Scholar 

  10. Jagielska G, Wolanczyk T, Komender J, Tomaszewicz-Libudzic C, Przedlacki J, Ostrowski K. Bone mineral density in adolescent girls with anorexia nervosa—a cross-sectional study. Eur Child Adolesc Psychiatry 2002;11:57–62

    Article  PubMed  CAS  Google Scholar 

  11. Misra M, Aggarwal A, Miller KK, Almazan C, Worley M, Soyka LA, et al. Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls. Pediatrics 2004;114:1574–83

    Article  PubMed  Google Scholar 

  12. Soyka L, Grinspoon S, Levitsky L, Herzog D, Klibanski A. The effects of anorexia nervosa on bone metabolism in female adolescents. J Clin Endocrinol Metab 1999;84:4489–96

    Article  PubMed  CAS  Google Scholar 

  13. Soyka L, Misra M, Frenchman A, Miller K, Grinspoon S, Schoenfeld D, et al. Abnormal bone mineral accrual in adolescent girls with anroexia nervosa. J Clin Endocrinol Metab 2002;87:4177–85

    Article  PubMed  CAS  Google Scholar 

  14. Schneider M, Fisher M, Weinerman S, Lesser M. Correlates of low bone density in females with anorexia nervosa. Int J Adolesc Med Health 2002;14:297–306

    PubMed  Google Scholar 

  15. Turner J, Bulsara M, McDermott B, Byrne G, Prince R, Forbes D. Predictors of low bone density in young adolescent females with anorexia nervosa and other dieting disorders. Int J Eat Disord 2001;30:245–51

    Article  PubMed  CAS  Google Scholar 

  16. Castro J, Toro J, Lazaro L, Pons F, Halperin I. Bone mineral density in male adolescents with anorexia nervosa. J Am Acad Child Adolesc Psychiatry 2002;41:613–8

    Article  PubMed  Google Scholar 

  17. Theintz G, Buchs B, Rizzoli R, Slosman D, Clavien H, Sizonenko P, et al. Longitudinal monitoring of bone mass accumulation in healthy adolescents: evidence for a marked reduction after 16 years of age at the levels of lumbar spine and femoral neck in female subjects. J Clin Endocrinol Metab 1992;75:1060–5

    Article  PubMed  CAS  Google Scholar 

  18. Bachrach L. Acquisition of optimal bone mass in childhood and adolescence. Trends Endocrinol Metab 2001;12:22–8

    Article  PubMed  CAS  Google Scholar 

  19. Biller B, Saxe V, Herzog D, Rosenthal D, Holzman S, Klibanski A. Mechanisms of osteoporosis in adult and adolescent women with anorexia nervosa. J Clin Endocrinol Metab 1989;68:548–54

    PubMed  CAS  Google Scholar 

  20. Grinspoon S, Thomas E, Pitts S, Gross E, Mickley D, Miller K, et al. Prevalence and predictive factors for regional osteopenia in women with anorexia nervosa. Ann Intern Med 2000;133:790–4

    PubMed  CAS  Google Scholar 

  21. Grinspoon S, Baum H, Lee K, Anderson E, Herzog D, Klibanski A. Effects of short-term recombinant human insulin-like growth factor I administration on bone turnover in osteopenic women with anorexia nervosa. J Clin Endocrinol Metab 1996;81:3864–70

    Article  PubMed  CAS  Google Scholar 

  22. Boyar R, Katz J, Finkelstein J, Kapen S, Weiner H, Weitzman E, et al. Anorexia nervosa. Immaturity of the 24-hour luteinizing hormone secretory pattern. N Engl J Med 1974;291:861–5

    Article  PubMed  CAS  Google Scholar 

  23. Cara J, Rosenfield R, Furlanetto R. A longitudinal study of the relationship of plasma somatomedin-C concentration to the pubertal growth spurt. Am J Dis Child 1987 May;141:562–4

    PubMed  CAS  Google Scholar 

  24. Riggs BL, Khosla S, Melton LJ, III. Sex steroids and the construction and conservation of the adult skeleton. Endocr Rev 2002;23:279–302

    Article  PubMed  CAS  Google Scholar 

  25. Gu G, Hentunen T, Nars M, Harkonen P, Vaananen H. Estrogen protects primary osteocytes against glucocorticoid-induced apoptosis. Apoptosis 2005;10:583–95

    Article  PubMed  CAS  Google Scholar 

  26. Iu M, Kaji H, Naito J, Sowa H, Sugimoto T, Chihara K. Low-dose parathyroid hormone and estrogen reverse alkaline phosphatase activity suppressed by dexamethasone in mouse osteoblastic cells. J Bone Miner Metab 2005;23:450–5

    Article  PubMed  CAS  Google Scholar 

  27. Michael HHP, Vaananen HK, Hentunen TA. Estrogen and testosterone use different cellular pathways to inhibit osteoclastogenesis and bone resorption. J Bone Miner Res 2005;20:2224–32

    Article  PubMed  CAS  Google Scholar 

  28. Klibanski A, Biller B, Schoenfeld D, Herzog D, Saxe V. The effects of estrogen administration on trabecular bone loss in young women with anorexia nervosa. J Clin Endocrinol Metab 1995;80:898–904

    Article  PubMed  CAS  Google Scholar 

  29. Miller KK, Grieco KA, Klibanski A. Testosterone administration in women with anorexia nervosa. J Clin Endocrinol Metab 2005;90:1428–33

    Article  PubMed  CAS  Google Scholar 

  30. Gordon C, Grace E, Emans S, Goodman E, Crawford M, Leboff M. Changes in bone turnover markers and menstrual function after short-term oral DHEA in young women with anorexia nervosa. J Bone Miner Res 1999;14:136–45

    Article  PubMed  CAS  Google Scholar 

  31. Castro J, Lazaro L, Pons F, Halperin I, Toro J. Predictors of bone mineral density reduction in adolescents with anorexia nervosa. J Am Acad Child Adolesc Psychiatry 2000;39:365–70

    Article  Google Scholar 

  32. Iketani T, Kiriike N, Nakanishi S, Nakasuji T. Effects of weight gain and resumption of menses on reduced bone density in patients with anorexia nervosa. Biol Psychiatry 1995;37:521–7

    Article  PubMed  CAS  Google Scholar 

  33. Miller KK, Grinspoon S, Gleysteen S, Grieco KA, Ciampa J, Breu J, et al. Preservation of neuroendocrine control of reproductive function despite severe undernutrition. J Clin Endocrinol Metab 2004;89:4434–8

    Article  PubMed  CAS  Google Scholar 

  34. Pomeroy C, Eckert E, Hu S, Eiken B, Mentink M, Crosby R, et al. Role of interleukin-6 and transforming growth factor-beta in anorexia nervosa. Biol Psychiatr 1994;36:836–9

    Article  CAS  Google Scholar 

  35. Kahl KG, Kruse N, Rieckmann P, Schmidt MH. Cytokine mRNA expression patterns in the disease course of female adolescents with anorexia nervosa. Psychoneuroendocrinology 2004;29:13–20

    Article  PubMed  CAS  Google Scholar 

  36. Monteleone P, Maes M, Fabrazzo M, Tortorella A, Lin A, Bosmans E, et al. Immunoendocrine findings in patients with eating disorders. Neuropsychobiol 1999;40:115–20

    Article  CAS  Google Scholar 

  37. Raymond N, Dysken M, Bettin K, Eckert E, Crow S, Markus K, et al. Cytokine production in patients with anorexia nervosa, bulimia nervosa, and obesity. Int J Eating Disord 2000;28:293–302

    Article  CAS  Google Scholar 

  38. Vaisman N, Hahn T, Karov Y, Sigler E, Barak Y, Barak V. Changes in cytokine production and impaired hematopoiesis in patients with anorexia nervosa: the effect of refeeding. Cytokine 2004;26:255–61

    Article  PubMed  CAS  Google Scholar 

  39. Corcos M, Guilbaud O, Chaouat G, Cayol V, Speranza M, Chambry J, et al. Cytokines and anorexia nervosa. Psychosom Med 2001;63:502–4

    PubMed  CAS  Google Scholar 

  40. Brambilla F, Monti D, Franceschi C. Plasma concentrations of interleukin-1-beta, interleukin-6 and tumor necrosis factor-alpha, and of their soluble receptors and receptor antagonist in anorexia nervosa. Psychiatry Res 2001;103:107–14

    Article  PubMed  CAS  Google Scholar 

  41. Misra M, Soyka LA, Miller KK, Herzog DB, Grinspoon S, de Chen D, et al. Serum osteoprotegerin in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 2003;88:3816–22

    Article  PubMed  CAS  Google Scholar 

  42. Grinspoon S, Thomas L, Miller K, Herzog D, Klibanski A. Effects of recombinant human IGF-I and oral contraceptive administration on bone density in anorexia nervosa. J Clin Endocrinol Metab 2002;87:2883–91

    Article  PubMed  CAS  Google Scholar 

  43. Golden NH, Lanzkowsky L, Schebendach J, Palestro CJ, Jacobson MS, Shenker IR. The effect of estrogen–progestin treatment on bone mineral density in anorexia nervosa. J Pediatr Adolesc Gynecol 2002;15:135–43

    Article  PubMed  Google Scholar 

  44. Munoz M, Morande G, Garcia-Centenera J, Hervas F, Pozo J, Argente J. The effects of estrogen administration on bone mineral density in adolescents with anorexia nervosa. Eur J Endocrinol 2002;146:45–50

    Article  PubMed  CAS  Google Scholar 

  45. Gordon CM, Goodman E, Emans SJ, Grace E, Becker KA, Rosen CJ, et al. Physiologic regulators of bone turnover in young women with anorexia nervosa. J Pediatr 2002;141:64–70

    Article  PubMed  CAS  Google Scholar 

  46. Hotta M, Shibasaki T, Sato K, Demura H. The importance of body weight history in the occurrence and recovery of osteoporosis in patients with anorexia nervosa: evaluation by dual X-ray absorptiometry and bone metabolic markers. Eur J Endocrinol 1998;139:276–83

    Article  PubMed  CAS  Google Scholar 

  47. Kooh S, Noriega E, Leslie K, Muller C, Harrison J. Bone mass and soft tissue composition in adolescents with anorexia nervosa. Bone 1996;19:181–8

    Article  PubMed  CAS  Google Scholar 

  48. Grinspoon S, Baum H, Peterson S, Klibanski A. Effects of rhIGF-I administration on bone turnover during short-term fasting. J Clin Invest 1995;96:900–6

    Article  PubMed  CAS  Google Scholar 

  49. Bachrach L, Katzman D, Litt I, Guido D, Marcus R. Recovery from osteopenia in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 1991;72:602–6

    Article  PubMed  CAS  Google Scholar 

  50. Hartman D, Crisp A, Rooney B, Rackow C, Atkinson R, Patel S. Bone density of women who have recovered from anorexia nervosa. Int J Eat Disord 2000;28:107–12

    Article  PubMed  CAS  Google Scholar 

  51. Zipfel S, Seibel MJ, Lowe B, Beumont PJ, Kasperk C, Herzog W. Osteoporosis in eating disorders: a follow-up study of patients with anorexia and bulimia nervosa. J Clin Endocrinol Metab 2001;86:5227–33

    Article  PubMed  CAS  Google Scholar 

  52. Golden N, Kreitzer P, Jacobson M, Chasalow F, Schebendach J, Freedman S, et al. Disturbances in growth hormone secretion and action in adolescents with anorexia nervosa. J Pediatr 1994;125:655–60

    Article  PubMed  CAS  Google Scholar 

  53. Counts D, Gwirtsman H, Carlsson L, Lesem M, Cutler G. The effect of anorexia nervosa and refeeding on growth hormone-binding protein, the insulin-like growth factors (IGFs), and the IGF-binding proteins. J Clin Endocrinol Metab 1992;75:762–7

    Article  PubMed  CAS  Google Scholar 

  54. Misra M, Miller K, Bjornson J, Hackman A, Aggarwal A, Chung J, et al. Alterations in growth hormone secretory dynamics in adolescent girls with anorexia nervosa and effects on bone metabolism. J Clin Endocrinol Metab 2003;88:5615–23

    Article  PubMed  CAS  Google Scholar 

  55. Argente J, Caballo N, Barrios V, Munoz M, Pozo J, Chowen J, et al. Multiple endocrine abnormalities of the growth hormone and insulin like growth factor-I axis in patients with anorexia nervosa: effect of long- and short-term weight recuperation. J Clin Endocrinol Metab 1997;82:2084–92

    Article  PubMed  CAS  Google Scholar 

  56. Scacchi M, Pincelli AI, Caumo A, Tomasi P, Delitala G, Baldi G, et al. Spontaneous nocturnal growth hormone secretion in anorexia nervosa. J Clin Endocrinol Metab 1997;82:3225–9

    Article  PubMed  CAS  Google Scholar 

  57. Stoving RK, Veldhuis JD, Flyvbjerg A, Vinten J, Hangaard J, Koldkjar OG, et al. Jointly amplified basal and pulsatile growth hormone (GH) secretion and increased process irregularity in women with anorexia nervosa: indirect evidence for disruption of feedback regulation within the GH-insulin-like growth factor I axis. J Clin Endocrinol Metab 1999;84:2056–63

    Article  PubMed  CAS  Google Scholar 

  58. Ohlsson C, Bengtsson B, Isaksson O, Andreassen T, Slootweg M. Growth hormone and bone. Endocr Rev 1998;19:55–79

    Article  PubMed  CAS  Google Scholar 

  59. Abrams S, Silber T, Esteban N, Vieira N, Stuff J, Meyers R, et al. Mineral balance and bone turnover in adolescents with anorexia nervosa. J Pediatr 1993;123:326–31

    Article  PubMed  CAS  Google Scholar 

  60. Abad V, Chrousos G, Reynolds J, Nieman L, Hill S, Weinstein R, et al. Glucocorticoid excess during adolescence leads to a major persistent deficit in bone mass and an increase in central body fat. J Bone Miner Res 2001;16:1879–85

    Article  PubMed  CAS  Google Scholar 

  61. Cino M, Greenberg G. Bone mineral density in Crohn’s disease: a longitudinal study of budesonide, prednisone, and nonsteroid therapy. Am J Gastroenterol 2002;97:915–21

    Article  PubMed  CAS  Google Scholar 

  62. Di Somma C, Pivonello R, Loche S, Faggiano A, Marzullo P, Di Sarno A, et al. Severe impairment of bone mass and turnover in Cushing’s disease: comparison between childhood-onset and adulthood-onset disease. Clin Endocrinol (Oxf) 2002;56:153–8

    Article  Google Scholar 

  63. Lettgen B, Jeken C, Reiners C. Influence of steroid medication on bone mineral density in children with nephrotic syndrome. Pediatr Nephrol 1994;8:667–70

    Article  PubMed  CAS  Google Scholar 

  64. Hermus A, Smals A, Swinkels L, Huysmans D, Pieters G, Sweep C, et al. Bone mineral density and bone turnover before and after surgical cure of Cushing’s syndrome. J Clin Endocrinol Metab 1995;80:2859–65

    Article  PubMed  CAS  Google Scholar 

  65. Misra M, Miller K, Almazan C, Ramaswamy K, Lapcharoensap W, Worley M, Neubauer G, Herzog D, Klibanski A. Alterations in cortisol secretory dynamics in adolescent girls with anorexia nervosa and effects on bone metabolism. J Clin Endocrinol Metab 2004:Submitted.

  66. Boyar R, Hellman L, Roffwarg H, Katz J, Zumoff B, O’Connor J, et al. Cortisol secretion and metabolism in anorexia nervosa. N Engl J Med 1977;296:190–3

    Article  PubMed  CAS  Google Scholar 

  67. Walsh B, Katz J, Levin J, Kream J, Fukushima D, Hellman L, et al. Adrenal activity in anorexia nervosa. Psychosom Med 1978;40:499–506

    PubMed  CAS  Google Scholar 

  68. Campfield L, Smith F, Guisez Y, Devos R, Burn P. Recombinant mouse OB protein: evidence for a peripheral signal linking adiposity and central neural networks. Science 1995;269:546–9

    Article  PubMed  CAS  Google Scholar 

  69. Pelleymounter M, Cullen M, Baker M, Hecht R, Winters D, Boone T, et al. Effects of the obese gene product on body weight regulation in ob/ob mice. Science 1995;269:540–3

    Article  PubMed  CAS  Google Scholar 

  70. Grinspoon S, Gulick T, Askari H, Landt M, Lee K, Anderson E, et al. Serum leptin levels in women with anorexia nervosa. J Clin Endocrinol Metab 1996;81:3861–3

    Article  PubMed  CAS  Google Scholar 

  71. Misra M, Miller KK, Almazan C, Ramaswamy K, Aggarwal A, Herzog DB, et al. Hormonal and body composition predictors of soluble leptin receptor, leptin, and free leptin index in adolescent girls with anorexia nervosa and controls and relation to insulin sensitivity. J Clin Endocrinol Metab 2004;89:3486–95

    Article  PubMed  CAS  Google Scholar 

  72. Misra M, Miller KK, Kuo K, Griffin K, Stewart V, Hunter E, et al. Secretory dynamics of leptin in adolescent girls with anorexia nervosa and healthy adolescents. Am J Physiol Endocrinol Metab:00041.2005

  73. Tolle V, Kadem M, Bluet-Pajot M-T, Frere D, Foulon C, Bossu C, et al. Balance in ghrelin and leptin plasma levels in anorexia nervosa patients and constitutionally thin women. J Clin Endocrinol Metab 2003;88:109–16

    Article  PubMed  CAS  Google Scholar 

  74. Heer M, Mika C, Grzella I, Heussen N, Herpertz-Dahlmann B. Bone turnover during inpatient nutritional therapy and outpatient follow-up in patients with anorexia nervosa compared with that in healthy control subjects. Am J Clin Nutr 2004;80:774–81

    PubMed  CAS  Google Scholar 

  75. Herpertz S, Albers N, Wagner R, Pelz B, Kopp W, Mann K, et al. Longitudinal changes of circadian leptin, insulin and cortisol plasma levels and their correlation during refeeding in patients with anorexia nervosa. Eur J Endocrinol 2000;142:373–9

    Article  PubMed  CAS  Google Scholar 

  76. Audi L, Mantzoros C, Vidal-Puig A, Vargas D, Gussinye M, Carrascosa A. Leptin in relation to resumption of menses in women with anorexia nervosa. Mol Psychiatr 1998;3:544–7

    Article  CAS  Google Scholar 

  77. Ducy P, Amling M, Takeda S, Priemel M, Schilling AF, Beil FT, et al. Leptin inhibits bone formation through a hypothalamic relay: a central control of bone mass. Cell 2000;100:197–207

    Article  PubMed  CAS  Google Scholar 

  78. Tschop M, Smiley D, Heiman M. Ghrelin induces adiposity in rodents. Nature 2000;407:908–13

    Article  PubMed  CAS  Google Scholar 

  79. Nakazato M, Murakami N, Date Y, Kojima M, Matsuo H, Kangawa K, et al. A role for ghrelin in the central regulation of feeding. Nature 2001;409:194–8

    Article  PubMed  CAS  Google Scholar 

  80. Tassone F, Broglio F, Destefanis S, Rovere S, Benso A, Gottero C, et al. Neuroendocrine and metabolic effects of acute ghrelin administration in human obesity. J Clin Endocrinol Metab 2003;88:5478–83

    Article  PubMed  CAS  Google Scholar 

  81. Takaya K, Ariyasu H, Kanamoto N, Iwakura H, Yoshimoto A, Harada M, et al. Ghrelin strongly stimulates growth hormone release in humans. J Clin Endocrinol Metab 2000;85:4908–11

    Article  PubMed  CAS  Google Scholar 

  82. Arvat E, Maccario M, Di Vito L, Broglio F, Benso A, Gottero C, et al. Endocrine activities of ghrelin, a natural growth hormone secretagogue (GHS), in humans: comparison and interactions with hexarelin, a nonnatural peptidyl GHS, and GH-releasing hormone. J Clin Endocrinol Metab 2001;86:1169–74

    Article  PubMed  CAS  Google Scholar 

  83. Tannenbaum GS, Epelbaum J, Bowers CY. Interrelationship between the novel peptide ghrelin and somatostatin/growth hormone-releasing hormone in regulation of pulsatile growth hormone secretion. Endocrinology 2003;144:967–74

    Article  PubMed  CAS  Google Scholar 

  84. Kojima S, Nakahara T, Nagai N, Muranaga T, Tanaka M, Yasuhara D, et al. Altered ghrelin and peptide YY responses to meals in bulimia nervosa. Clin Endocrinol (Oxf) 2005;62:74–8

    Article  CAS  Google Scholar 

  85. Vulliemoz NR, Xiao E, Xia-Zhang L, Germond M, Rivier J, Ferin M. Decrease in luteinizing hormone pulse frequency during a five-hour peripheral ghrelin infusion in the ovariectomized rhesus monkey. J Clin Endocrinol Metab 2004;89:5718–23

    Article  PubMed  CAS  Google Scholar 

  86. Maccarinelli G, Sibilia V, Torsello A, Raimondo F, Pitto M, Giustina A, et al. Ghrelin regulates proliferation and differentiation of osteoblastic cells. J Endocrinol 2005;184:249–56

    Article  PubMed  CAS  Google Scholar 

  87. Hotta M, Ohwada R, Katakami H, Shibasaki T, Hizuka N, Takano K. Plasma levels of intact and degraded ghrelin and their responses to glucose infusion in anorexia nervosa. J Clin Endocrinol Metab 2004;89:5707–12

    Article  PubMed  CAS  Google Scholar 

  88. Misra M, Miller KK, Herzog DB, Ramaswamy K, Aggarwal A, Almazan C, et al. Growth hormone and ghrelin responses to an oral glucose load in adolescent girls with anorexia nervosa and controls. J Clin Endocrinol Metab 2004;89:1605–12

    Article  PubMed  CAS  Google Scholar 

  89. Misra M, Miller KK, Kuo K, Griffin K, Stewart V, Hunter E, Herzog DB, Klibanski A. Secretory dynamics of ghrelin in adolescent girls with anorexia nervosa and healthy adolescents. Am J Physiol Endocrinol Metab:00615.2004

  90. Misra M, Miller K, Stewart V, Hunter E, Kuo K, Herzog D, Klibanski A. Ghrelin and bone metabolism in adolescent girls with anorexia nervosa and healthy adolescents. J Clin Endocrinol Metab:Jul 5 2005; 90:5082–7

    Google Scholar 

  91. Batterham R, Cowley M, Small C, Herzog H, Cohen M, Dakin C, et al. Gut hormone PYY(3–36) physiologically inhibits food intake. Nature 2002;418:650–4

    Article  PubMed  CAS  Google Scholar 

  92. Stock S, Leichner P, Wong ACK, Ghatei MA, Kieffer TJ, Bloom SR, et al. Ghrelin, Peptide YY, glucose-dependent insulinotropic polypeptide, and hunger responses to a mixed meal in anorexic, obese, and control female adolescents. J Clin Endocrinol Metab 2005;90:2161–8

    Article  PubMed  CAS  Google Scholar 

  93. Misra M, Miller K, Tsai P, Gallagher K, Lin A, Lee N, et al. Elevated Peptide YY levels in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 2006;91:1027–33

    Article  PubMed  CAS  Google Scholar 

  94. Baldock PA, Sainsbury A, Couzens M, Enriquez RF, Thomas GP, Gardiner EM, et al. Hypothalamic Y2 receptors regulate bone formation. J Clin Invest 2002;109:915–21

    Article  PubMed  CAS  Google Scholar 

  95. Golden NH, Iglesias EA, Jacobson MS, Carey D, Meyer W, Schebendach J, et al. Alendronate for the treatment of osteopenia in anorexia nervosa: a randomized, double-blind, placebo-controlled trial 10.1210/jc.2004-1659. J Clin Endocrinol Metab 2005;90:3179–85

    Article  PubMed  CAS  Google Scholar 

  96. Miller KK, Grieco KA, Mulder J, Grinspoon S, Mickley D, Yehezkel R, et al. Effects of risedronate on bone density in anorexia nervosa. J Clin Endocrinol Metab 2004;89:3903–6

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

This work is supported in part by National Institutes of Health grants MO1-RR-01066, RO1DK062249, RO1DK52625 and K23 RR018851.

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  1. Pediatric Endocrine Unit, Massachusetts General Hospital for Children, Boston, MA, USA

    Madhusmita Misra

  2. Neuroendocrine Unit, Massachusetts General Hospital, Boston, MA, USA

    Madhusmita Misra & Anne Klibanski

  3. Harvard Medical School, Boston, MA, USA

    Madhusmita Misra & Anne Klibanski

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Correspondence to Madhusmita Misra.

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Misra, M., Klibanski, A. Anorexia nervosa and osteoporosis. Rev Endocr Metab Disord 7, 91–99 (2006). https://doi.org/10.1007/s11154-006-9005-1

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