ESPE Abstracts (2015) 84 P-2-221

Evidence of a Link Between Resting Energy Expenditure and Bone Remodelling, Glucose Homeostasis and Adipokine Variations in Adolescent Girls with Anorexia Nervosa

Laurent Maimouna,b, Sebastien Guillaumec, Patrick Lefbvred, Pascal Philiberte, Helena Bertetf, Marie-Christine Picotf,g, Laura Gasparih, Françoise Parise,i, Maude Sennecc, Anne-Marie Dupuyse, Philippe Courtetc, Eric Thomasj, Denis Mariano-Goularta, Jacques Bringerd, Eric Renardd,k & Charles Sultani


aCentre Hospitalier Régional Universitaire (CHRU) Montpellier et Université Montpellier 1 (UMI), Service de Médecine Nucléaire, Hôpital Lapeyronie, Montpellier, France; bPhysiologie et Médecine Expérimentale du Cœur et des Muscles, Institut National de la Santé et de la Recherche Médicale (INSERM) U1046, Montpellier, France; cDépartement d’Urgence et Post-Urgence Psychiatrique, Hôpital Lapeyronie, CHRU Montpellier, UMI, INSERM U1061, Montpellier, France; dDépartement d’Endocrinologie, Diabète, Nutrition, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France; eDépartement de Biochimie et d’Hormonologie, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France; fUnité de Recherche Clinique et Epidémiologie, Hôpital Lapeyronie, CHRU Montpellier, Montpellier, France; gCIC INSERM 1001, Hôpital Gui de Chauliac, Montpellier, France, hDépartement de Pédiatrie, Hôpital Caremeau, Nîmes, France; iUnité d’Endocrinologie et Gynécologie Pédiatrique, Département de Pédiatrie, Hôpital Arnaud de Villeneuve, Montpellier, France; jService de Rhumatologie, Montpellier, France; kInstitut de Génomique Fonctionnelle, CNRS UMR 5203/INSERM U661, Montpellier, France


Purpose: Low areal bone mineral density (aBMD) is a well-known consequence of anorexia nervosa (AN). However, the impact of reduced energy expenditure on bone metabolism is unknown. This study assessed the effects of energy deficiency on bone remodelling and its potential interactions with glucose homeostasis and adipose tissue-derived hormones in AN, a clinical model for reduced energy expenditure.

Methods: 50 women with AN and 50 age-matched controls (mean age 18.1±2.7 and 18.0±2.1 years respectively) were enrolled. aBMD were determined with DXA. Resting energy expenditure (REEm), a marker of energy status, was indirectly assessed by calorimetry. Bone turnover markers, undercarboxyated osteocalcin (ucOC), parameters of glucose homeostasis, adipokines and growth factors were concomitantly evaluated.

Results: AN patients presented low aBMD at all bone sites. REEm, bone formation markers, ucOC, glucose, insulin, HOMA-IR, leptin and, IGF-1 were significantly reduced, whereas the bone resorption marker, leptin receptor (sOB-R) and adiponectin were elevated in AN compared with CON. In AN patients, REEm was positively correlated with weight, BMI, whole body (WB) fat mass, WB fat-free soft tissue, markers of bone formation, glucose, insulin, HOMA-IR, leptin, and IGF1, and negatively correlated with the bone resorption marker and sOB-R. Biological parameters, aBMD excepted, appeared more affected by the weight variation in the last 6 months than by the disease duration.

Conclusions: The strong interrelationships between REEm and bone remodelling, glucose homeostasis and adipokines underscore the importance of preventing energy deficiency to limit short- and long-term bone demineralisation and hormonal alterations in AN patients.

Funding: This work was supported by the Centre Hospitalier Regional Universitaire (CHRU) of Montpellier (AOI UF 8751 and UF 8854) and a grant from the Société Française d’Endocrinologie Pédiatrique (SFEDP).

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