This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Anorexia nervosa (AN) is the third most common chronic illness among adolescent girls, with a prevalence of 0.2-1%. Osteopenia is a major co-morbid complication of anorexia nervosa both in female adolescents and in adult women with this eating disorder. Improved understanding of bone mineral metabolism and of factors that predict recovery of bone mineral accretion is critical to develop therapeutic strategies to maximize bone mass in girls with onset of AN in adolescence. Although profound estrogen deficiency is seen in AN, no controlled studies have investigated the effects of estrogen administration on this population. In this randomized, placebo controlled, double blinded study, we plan to examine the effects of administration of estrogen as a low dose pill (in adolescent girls with AN, bone age 13.5-15 years) or as a transdermal patch (in girls with bone age > 15 years) for 1 and 1/2 years on bone mass in adolescent girls with this disorder.
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