Bone Marrow Changes in Adolescent Girls With Anorexia Nervosa
نویسندگان
چکیده
Early osteoporosis is common among adolescent girls with anorexia nervosa (AN) and may result from premature conversion of red (RM) to yellow bone marrow. We performed right knee magnetic resonance imaging (MRI) on a 1.0 T extremity scanner in 20 patients and 20 healthy controls, aged 16.2 +/- 1.6 years (mean +/- SD). Coronal T(1)-weighted (T(1)W) images and T(1) maps were generated from T(1) relaxometry images. Blinded radiologists visually assessed RM in the distal femoral and proximal tibial metaphyses in T(1)W images using a scale of signal intensity from 0 (homogeneous hyperintensity, no RM) to 4 (all dark, complete RM). Subjects with AN exhibited nearly twofold lower metaphyseal RM scores in both the femur (0.64 versus 1.22, p = .03) and tibia (0.54 versus 0.96, p = .08). In relaxometric measurements of four selected regions (femur and tibia amd epiphysis and metaphysis), subjects with AN showed higher mean epiphyseal but lower metaphyseal T(1). The net AN-control difference between epiphysis and metaphysis was 70 ms in the femur (+31 versus -35 ms, p = .02) and of smaller magnitude in the tibia. In relaxometry data from the full width of the femur adjacent to the growth plate, AN subjects showed mean T(1) consistently lower than in controls by 30 to 50 ms in virtually every part of the sampling region. These findings suggest that adolescents with AN exhibit premature conversion of hematopoietic to fat cells in the marrow of the peripheral skeleton potentially owing to adipocyte over osteoblast differentiation in the mesenchymal stem cell pool.
منابع مشابه
Early bone marrow conversion in adolescents with Anorexia Nervosa: A T1 Relaxometry Study
Introduction: T1-weighted imaging of the knees of adolescent girls with anorexia nervosa (AN) has been found to show consistently higher signal intensity and greater homogeneity in the femur and tibia as compared to normal adolescents, who typically exhibit striations and regions of lower signal, representing hematopoietic marrow. We performed T1 relaxometry measurements on a cohort of adolesce...
متن کاملSerum osteoprotegerin in adolescent girls with anorexia nervosa.
Low bone mineral density (BMD) in adolescents with anorexia nervosa (AN) is associated with a low bone turnover state. Osteoprotegerin (OPG), a cytokine that acts as a decoy receptor for receptor activator of nuclear factor-kappaB ligand, decreases bone resorption by inhibiting differentiation of osteoclast precursors and activation of mature osteoclasts, and by stimulating osteoclast apoptosis...
متن کاملDepression in anorexia nervosa: a risk factor for osteoporosis.
CONTEXT Both anorexia nervosa (AN) and depression are associated with osteoporosis. We hypothesized that adolescent girls with AN and depression will have lower bone mineral density (BMD) than anorexic girls without depression. OBJECTIVE The objective of this study was to investigate whether depression is an independent risk factor for osteoporosis in anorexic adolescent girls. DESIGN This ...
متن کاملAmenorrhea and bone health in adolescents and young women.
PURPOSE OF REVIEW We present an update on amenorrhea in adolescent girls and young women. Amenorrhea may herald the onset of estrogen deficiency, which can adversely affect peak bone mass and ultimate risk of osteoporosis. RECENT FINDINGS Adolescence is a critical period for bone accretion. Important modifiable factors that optimize bone accretion during this time are calcium intake, vitamin ...
متن کامل