Anorexia nervosa is an increasingly common disorder in adolescent girls with a prevalence of 0.2 to 1.0% in Western societies. Adolescence is a critical time for bone mineral accretion as between 60-90% of peak bone mass is established during this time and peak bone mass is a major determinant of osteoporosis and fracture risk throughout life. Osteopenia is a complication of anorexia nervosa in more than half of affected women and is associated with clinical fractures. Little is known about the pathogenesis of osteopenia in adolescents and there are no established therapies to maximize peak bone mass and prevent fractures. Although anorexia nervosa is associated with profound estrogen deficiency and estrogen is known to be a critical factor in bone development, the effects of estrogen administration have not been investigated in adolescents with this disorder. In the current proposal, disordered bone metabolism and body composition will be investigated and the effects of anorexia nervosa on growth hormone and nutritionally dependent endpoints will be examined. In the first Specific Aim we will prospectively investigate the disordered state of bone mineral accretion in pubertal adolescents with anorexia nervosa. Predictive factors leading to low bone density will be studied as well as the effect of anorexia nervosa on linear growth, predicted height and growth hormone secretion. In the second Aim we will investigate the hypothesis that estrogen administration given to adolescents with anorexia nervosa, in a bone-age, dose-dependent manner will increase bone density during the development of peak bone mass, stimulate IGF-I levels and stimulate linear growth in girls with immature bone age. These studies will be essential in developing strategies to address the profound loss of bone accrual seen in this large population of adolescent girls at high fracture risk.
| Fazeli, Pouneh K; Klibanski, Anne (2018) Effects of Anorexia Nervosa on Bone Metabolism. Endocr Rev 39:895-910 |
| Singhal, Vibha; Tulsiani, Shreya; Campoverde, Karen Joanie et al. (2018) Impaired bone strength estimates at the distal tibia and its determinants in adolescents with anorexia nervosa. Bone 106:61-68 |
| Misra, Madhusmita; Ackerman, Kathryn E; Bredella, Miriam A et al. (2017) Racial Differences in Bone Microarchitecture and Estimated Strength at the Distal Radius and Distal Tibia in Older Adolescent Girls: a Cross-Sectional Study. J Racial Ethn Health Disparities 4:587-598 |
| Kandemir, Nurgun; Becker, Kendra; Slattery, Meghan et al. (2017) Impact of low-weight severity and menstrual status on bone in adolescent girls with anorexia nervosa. Int J Eat Disord 50:359-369 |
| Baskaran, Charumathi; Carson, Traci L; Campoverde Reyes, Karen J et al. (2017) Macronutrient intake associated with weight gain in adolescent girls with anorexia nervosa. Int J Eat Disord 50:1050-1057 |
| Misra, Madhusmita; Golden, Neville H; Katzman, Debra K (2016) State of the art systematic review of bone disease in anorexia nervosa. Int J Eat Disord 49:276-92 |
| Misra, Madhusmita; Klibanski, Anne (2016) Anorexia Nervosa and Its Associated Endocrinopathy in Young People. Horm Res Paediatr 85:147-57 |
| Misra, Madhusmita; Klibanski, Anne (2014) Anorexia nervosa and bone. J Endocrinol 221:R163-76 |
| Faje, Alexander T; Fazeli, Pouneh K; Miller, Karen K et al. (2014) Fracture risk and areal bone mineral density in adolescent females with anorexia nervosa. Int J Eat Disord 47:458-66 |
| Singhal, Vibha; Misra, Madhusmita; Klibanski, Anne (2014) Endocrinology of anorexia nervosa in young people: recent insights. Curr Opin Endocrinol Diabetes Obes 21:64-70 |
Showing the most recent 10 out of 53 publications
