Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa
Anorexia nervosa (AN) is prevalent in adolescents and is associated with decreased bone mineral accrual at a time critical for optimizing bone mass. Low BMD in AN is a consequence of nutritional and hormonal alterations, including hypogonadism and low estradiol levels. Effective therapeutic strategi...
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| Veröffentlicht in: | Journal of bone and mineral research 2011-10, Vol.26 (10), p.2430-2438 |
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| creator | Misra, Madhusmita Katzman, Debra Miller, Karen K Mendes, Nara Snelgrove, Deirdre Russell, Melissa Goldstein, Mark A Ebrahimi, Seda Clauss, Laura Weigel, Thomas Mickley, Diane Schoenfeld, David A Herzog, David B Klibanski, Anne |
| description | Anorexia nervosa (AN) is prevalent in adolescents and is associated with decreased bone mineral accrual at a time critical for optimizing bone mass. Low BMD in AN is a consequence of nutritional and hormonal alterations, including hypogonadism and low estradiol levels. Effective therapeutic strategies to improve BMD in adolescents with AN have not been identified. Specifically, high estrogen doses given as an oral contraceptive do not improve BMD. The impact of physiologic estrogen doses that mimic puberty on BMD has not been examined. We enrolled 110 girls with AN and 40 normal‐weight controls 12 to 18 years of age of similar maturity. Subjects were studied for 18 months. Mature girls with AN (bone age [BA] ≥15 years, n = 96) were randomized to 100 µg of 17β‐estradiol (with cyclic progesterone) or placebo transdermally for 18 months. Immature girls with AN (BA |
| doi_str_mv | 10.1002/jbmr.447 |
| format | Article |
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Low BMD in AN is a consequence of nutritional and hormonal alterations, including hypogonadism and low estradiol levels. Effective therapeutic strategies to improve BMD in adolescents with AN have not been identified. Specifically, high estrogen doses given as an oral contraceptive do not improve BMD. The impact of physiologic estrogen doses that mimic puberty on BMD has not been examined. We enrolled 110 girls with AN and 40 normal‐weight controls 12 to 18 years of age of similar maturity. Subjects were studied for 18 months. Mature girls with AN (bone age [BA] ≥15 years, n = 96) were randomized to 100 µg of 17β‐estradiol (with cyclic progesterone) or placebo transdermally for 18 months. Immature girls with AN (BA < 15 years, n = 14) were randomized to incremental low‐dose oral ethinyl‐estradiol (3.75 µg daily from 0 to 6 months, 7.5 µg from 6 to 12 months, 11.25 µg from 12 to 18 months) to mimic pubertal estrogen increases or placebo for 18 months. All BMD measures assessed by dual‐energy X‐ray absorptiometry (DXA) were lower in girls with AN than in control girls. At baseline, girls with AN randomized to estrogen (AN E + ) did not differ from those randomized to placebo (AN E–) for age, maturity, height, BMI, amenorrhea duration, and BMD parameters. Spine and hip BMD Z‐scores increased over time in the AN E+ compared with the AN E– group, even after controlling for baseline age and weight. It is concluded that physiologic estradiol replacement increases spine and hip BMD in girls with AN. © 2011 American Society for Bone and Mineral Research</description><identifier>ISSN: 0884-0431</identifier><identifier>EISSN: 1523-4681</identifier><identifier>DOI: 10.1002/jbmr.447</identifier><identifier>PMID: 21698665</identifier><identifier>CODEN: JBMREJ</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Absorptiometry, Photon ; Adolescent ; ADOLESCENTS ; Age ; Anorexia ; ANOREXIA NERVOSA ; Anorexia Nervosa - physiopathology ; Biological and medical sciences ; BONE DENSITY ; BONE METABOLISM ; BONE TURNOVER ; Child ; ESTROGEN ; Estrogen Replacement Therapy ; Female ; Fundamental and applied biological sciences. Psychology ; Hormone replacement therapy ; Humans ; IGF‐1 ; Skeleton and joints ; Teenagers ; TRANSDERMAL ; Vertebrates: osteoarticular system, musculoskeletal system</subject><ispartof>Journal of bone and mineral research, 2011-10, Vol.26 (10), p.2430-2438</ispartof><rights>Copyright © 2011 American Society for Bone and Mineral Research</rights><rights>2015 INIST-CNRS</rights><rights>Copyright © 2011 American Society for Bone and Mineral Research.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5327-2bb912084d303fe5ed931bb9813d430f6a8a113ba9a5daa324fdae68027d35e23</citedby><cites>FETCH-LOGICAL-c5327-2bb912084d303fe5ed931bb9813d430f6a8a113ba9a5daa324fdae68027d35e23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjbmr.447$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjbmr.447$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24563580$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21698665$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Misra, Madhusmita</creatorcontrib><creatorcontrib>Katzman, Debra</creatorcontrib><creatorcontrib>Miller, Karen K</creatorcontrib><creatorcontrib>Mendes, Nara</creatorcontrib><creatorcontrib>Snelgrove, Deirdre</creatorcontrib><creatorcontrib>Russell, Melissa</creatorcontrib><creatorcontrib>Goldstein, Mark A</creatorcontrib><creatorcontrib>Ebrahimi, Seda</creatorcontrib><creatorcontrib>Clauss, Laura</creatorcontrib><creatorcontrib>Weigel, Thomas</creatorcontrib><creatorcontrib>Mickley, Diane</creatorcontrib><creatorcontrib>Schoenfeld, David A</creatorcontrib><creatorcontrib>Herzog, David B</creatorcontrib><creatorcontrib>Klibanski, Anne</creatorcontrib><title>Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa</title><title>Journal of bone and mineral research</title><addtitle>J Bone Miner Res</addtitle><description>Anorexia nervosa (AN) is prevalent in adolescents and is associated with decreased bone mineral accrual at a time critical for optimizing bone mass. Low BMD in AN is a consequence of nutritional and hormonal alterations, including hypogonadism and low estradiol levels. Effective therapeutic strategies to improve BMD in adolescents with AN have not been identified. Specifically, high estrogen doses given as an oral contraceptive do not improve BMD. The impact of physiologic estrogen doses that mimic puberty on BMD has not been examined. We enrolled 110 girls with AN and 40 normal‐weight controls 12 to 18 years of age of similar maturity. Subjects were studied for 18 months. Mature girls with AN (bone age [BA] ≥15 years, n = 96) were randomized to 100 µg of 17β‐estradiol (with cyclic progesterone) or placebo transdermally for 18 months. Immature girls with AN (BA < 15 years, n = 14) were randomized to incremental low‐dose oral ethinyl‐estradiol (3.75 µg daily from 0 to 6 months, 7.5 µg from 6 to 12 months, 11.25 µg from 12 to 18 months) to mimic pubertal estrogen increases or placebo for 18 months. All BMD measures assessed by dual‐energy X‐ray absorptiometry (DXA) were lower in girls with AN than in control girls. At baseline, girls with AN randomized to estrogen (AN E + ) did not differ from those randomized to placebo (AN E–) for age, maturity, height, BMI, amenorrhea duration, and BMD parameters. Spine and hip BMD Z‐scores increased over time in the AN E+ compared with the AN E– group, even after controlling for baseline age and weight. It is concluded that physiologic estradiol replacement increases spine and hip BMD in girls with AN. © 2011 American Society for Bone and Mineral Research</description><subject>Absorptiometry, Photon</subject><subject>Adolescent</subject><subject>ADOLESCENTS</subject><subject>Age</subject><subject>Anorexia</subject><subject>ANOREXIA NERVOSA</subject><subject>Anorexia Nervosa - physiopathology</subject><subject>Biological and medical sciences</subject><subject>BONE DENSITY</subject><subject>BONE METABOLISM</subject><subject>BONE TURNOVER</subject><subject>Child</subject><subject>ESTROGEN</subject><subject>Estrogen Replacement Therapy</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Hormone replacement therapy</subject><subject>Humans</subject><subject>IGF‐1</subject><subject>Skeleton and joints</subject><subject>Teenagers</subject><subject>TRANSDERMAL</subject><subject>Vertebrates: osteoarticular system, musculoskeletal system</subject><issn>0884-0431</issn><issn>1523-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkluLFDEQhYMo7rgK_gJpENGXXnOf5EXQxSsriuhzqO6unsmQSWaTmV3n35tmx10V1KdA5eNU1alDyENGTxil_PmqW-cTKee3yIwpLlqpDbtNZtQY2VIp2BG5V8qKUqqV1nfJEWfaGq3VjMDn5b74FNLC9w2WbU4LjE3GTYAe1xi3jY99RihYmi5FbAaMxW_3tdzAkAKWfoIWPofSXPrtsoGYMn730ETMF6nAfXJnhFDwweE9Jt_evP56-q49-_T2_enLs7ZXgs9b3nWWcWrkIKgYUeFgBas1w8QgBR01GGBMdGBBDQCCy3EA1Iby-SAUcnFMXlzpbnbdGodprAzBbbJfQ967BN79_hP90i3ShROCSilsFXh6EMjpfFe9cGtftwsBIqZdcZZyoSU3_yeNlYYpaaehnv2TZGbOjbBciYo-_gNdpV2O1bJK1VsxIa28EexzKiXjeL0go27Kgpuy4GoWKvroV0OuwZ_Hr8CTAwClhzBmiL0vN5xUWihDK9decZc-4P6vDd2HVx-_TI1_AFNqzF0</recordid><startdate>201110</startdate><enddate>201110</enddate><creator>Misra, Madhusmita</creator><creator>Katzman, Debra</creator><creator>Miller, Karen K</creator><creator>Mendes, Nara</creator><creator>Snelgrove, Deirdre</creator><creator>Russell, Melissa</creator><creator>Goldstein, Mark A</creator><creator>Ebrahimi, Seda</creator><creator>Clauss, Laura</creator><creator>Weigel, Thomas</creator><creator>Mickley, Diane</creator><creator>Schoenfeld, David A</creator><creator>Herzog, David B</creator><creator>Klibanski, Anne</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley</general><general>Wiley Subscription Services, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TS</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201110</creationdate><title>Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa</title><author>Misra, Madhusmita ; Katzman, Debra ; Miller, Karen K ; Mendes, Nara ; Snelgrove, Deirdre ; Russell, Melissa ; Goldstein, Mark A ; Ebrahimi, Seda ; Clauss, Laura ; Weigel, Thomas ; Mickley, Diane ; Schoenfeld, David A ; Herzog, David B ; Klibanski, Anne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5327-2bb912084d303fe5ed931bb9813d430f6a8a113ba9a5daa324fdae68027d35e23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Absorptiometry, Photon</topic><topic>Adolescent</topic><topic>ADOLESCENTS</topic><topic>Age</topic><topic>Anorexia</topic><topic>ANOREXIA NERVOSA</topic><topic>Anorexia Nervosa - physiopathology</topic><topic>Biological and medical sciences</topic><topic>BONE DENSITY</topic><topic>BONE METABOLISM</topic><topic>BONE TURNOVER</topic><topic>Child</topic><topic>ESTROGEN</topic><topic>Estrogen Replacement Therapy</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Hormone replacement therapy</topic><topic>Humans</topic><topic>IGF‐1</topic><topic>Skeleton and joints</topic><topic>Teenagers</topic><topic>TRANSDERMAL</topic><topic>Vertebrates: osteoarticular system, musculoskeletal system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Misra, Madhusmita</creatorcontrib><creatorcontrib>Katzman, Debra</creatorcontrib><creatorcontrib>Miller, Karen K</creatorcontrib><creatorcontrib>Mendes, Nara</creatorcontrib><creatorcontrib>Snelgrove, Deirdre</creatorcontrib><creatorcontrib>Russell, Melissa</creatorcontrib><creatorcontrib>Goldstein, Mark A</creatorcontrib><creatorcontrib>Ebrahimi, Seda</creatorcontrib><creatorcontrib>Clauss, Laura</creatorcontrib><creatorcontrib>Weigel, Thomas</creatorcontrib><creatorcontrib>Mickley, Diane</creatorcontrib><creatorcontrib>Schoenfeld, David A</creatorcontrib><creatorcontrib>Herzog, David B</creatorcontrib><creatorcontrib>Klibanski, Anne</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of bone and mineral research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Misra, Madhusmita</au><au>Katzman, Debra</au><au>Miller, Karen K</au><au>Mendes, Nara</au><au>Snelgrove, Deirdre</au><au>Russell, Melissa</au><au>Goldstein, Mark A</au><au>Ebrahimi, Seda</au><au>Clauss, Laura</au><au>Weigel, Thomas</au><au>Mickley, Diane</au><au>Schoenfeld, David A</au><au>Herzog, David B</au><au>Klibanski, Anne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa</atitle><jtitle>Journal of bone and mineral research</jtitle><addtitle>J Bone Miner Res</addtitle><date>2011-10</date><risdate>2011</risdate><volume>26</volume><issue>10</issue><spage>2430</spage><epage>2438</epage><pages>2430-2438</pages><issn>0884-0431</issn><eissn>1523-4681</eissn><coden>JBMREJ</coden><abstract>Anorexia nervosa (AN) is prevalent in adolescents and is associated with decreased bone mineral accrual at a time critical for optimizing bone mass. Low BMD in AN is a consequence of nutritional and hormonal alterations, including hypogonadism and low estradiol levels. Effective therapeutic strategies to improve BMD in adolescents with AN have not been identified. Specifically, high estrogen doses given as an oral contraceptive do not improve BMD. The impact of physiologic estrogen doses that mimic puberty on BMD has not been examined. We enrolled 110 girls with AN and 40 normal‐weight controls 12 to 18 years of age of similar maturity. Subjects were studied for 18 months. Mature girls with AN (bone age [BA] ≥15 years, n = 96) were randomized to 100 µg of 17β‐estradiol (with cyclic progesterone) or placebo transdermally for 18 months. Immature girls with AN (BA < 15 years, n = 14) were randomized to incremental low‐dose oral ethinyl‐estradiol (3.75 µg daily from 0 to 6 months, 7.5 µg from 6 to 12 months, 11.25 µg from 12 to 18 months) to mimic pubertal estrogen increases or placebo for 18 months. All BMD measures assessed by dual‐energy X‐ray absorptiometry (DXA) were lower in girls with AN than in control girls. At baseline, girls with AN randomized to estrogen (AN E + ) did not differ from those randomized to placebo (AN E–) for age, maturity, height, BMI, amenorrhea duration, and BMD parameters. Spine and hip BMD Z‐scores increased over time in the AN E+ compared with the AN E– group, even after controlling for baseline age and weight. It is concluded that physiologic estradiol replacement increases spine and hip BMD in girls with AN. © 2011 American Society for Bone and Mineral Research</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>21698665</pmid><doi>10.1002/jbmr.447</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Absorptiometry, Photon Adolescent ADOLESCENTS Age Anorexia ANOREXIA NERVOSA Anorexia Nervosa - physiopathology Biological and medical sciences BONE DENSITY BONE METABOLISM BONE TURNOVER Child ESTROGEN Estrogen Replacement Therapy Female Fundamental and applied biological sciences. Psychology Hormone replacement therapy Humans IGF‐1 Skeleton and joints Teenagers TRANSDERMAL Vertebrates: osteoarticular system, musculoskeletal system |
| title | Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa |
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