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Specific effects of anorexia nervosa and obesity on bone mineral density and bone turnover in young women

Maïmoun L1,2Garnero P3Mura T4Nocca D5Lefebvre P6Philibert P7Seneque M8Gaspari L9Vauchot F1Courtet P8Sultan A2,10Piketty ML11Sultan C9Renard E6,12,13Guillaume S8Mariano-Goulart D1,2.

J Clin Endocrinol Metab. 2019 Dec 10. pii: dgz259. doi: 10.1210/clinem/dgz259. [Epub ahead of print]





The threefold aim was to (1) compare areal bone mineral density (aBMD), bone turnover markers, and periostin levels in young women with either anorexia nervosa (AN) or obesity (OB) and controls (CON); (2) model the profiles according to age; and (3) determine the parameters associated with aBMD.


One hundred and fifty-two young women with ages ranging from 16.0 to 27.0 years were subdivided into three groups (AN, OB, CON). The CON group was age-matched by ±6 months. aBMD, bone turnover markers, and periostin levels were evaluated.


aBMD modeling showed that hip aBMD was higher in OB than in the other two groups from 19 yrs, and AN presented lower values than CON from 21 yrs. aBMD at the lumbar spine was higher in older OB and CON women, starting from 20 to 22 yrs, but in AN the difference with the other two groups increased with age. Periostin levels were lower in OB than in AN or CON, but no variation with age was observed. Compared with controls, OB and AN presented similarly lower markers of bone formation, although markers of bone resorption were lower in OB and higher in AN. A modeling approach showed that markers of bone formation and resorption were lower in older than in younger CON, whereas the values of these bone markers remained relatively constant in AN and OB. In all groups, lean body mass (LBM) was the parameter most positively correlated with aBMD.


This study demonstrated that weight extremes (AN or OB) influence aBMD, bone remodeling and periostin profiles. Moreover, factors related to aBMD were specific to each condition, but LBM was the parameter most consistently associated with aBMD.