#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

In adolescents with anorexia nervosa the number of circulating blood cells associates with bone mineral density


Authors: Čagalová Alžbeta 1;  Kovalčíková Gaál Alexandra 1;  Tichá Ubica 1;  Šebeková Katarína 2;  Podracká Udmila 1
Authors place of work: Detská klinika Lekárskej fakulty Univerzity Komenského a Národného ústavu detských chorôb, Bratislava 1;  Ústav molekulárnej biomedicíny, Lekárska fakulta Univerzity Komenského, Bratislava 2
Published in the journal: Čes-slov Pediat 2022; 77 (3): 158-165.
Category: Original Papers

Summary

Background: Anorexia nervosa (AN) is a serious psychosomatic disorder that develops especially in adolescence. Severe nutritional deprivation with disruption of the internal environment andhormonal dysregulation affects hematopoiesis and bone metabolism. The aim of this study was to determine whether there is an association between hematopoiesis disruption and reduced bone metabolism in girls with AN.

Methods: Twenty-five girls with AN (mean age 16.2 ± 1.0) and 13 healthy controls with normal weight (mean age 16.7 ± 1.2) were enrolled in the study. Blood counts and markers of bone metabolism were analysed using standard laboratory methods. Bone mineral density was examined by dual X-ray absorptiometry. The results were evaluated by standard mathematical and statistical methods.

Results: Blood cells counts and concentrations of markers of bone metabolism (phosphorus, ALP, P1NP, osteocalcin) were significantly lower in girls with AN than in healthy controls (p ≤ 0.05). The group with AN had significantly lower bone mineral density (BMD) and BMD Z-score in the left hip (p ≤ 0.05) and lower bone mineral content (BMC) in the total body less head measurement (TBLH, p ≤ 0.05). Bone metabolism markers (phosphorus, ALP, P1NP, osteocalcin) positively correlated with leukocyte and erythrocyte counts (p ≤ 0.05). Leukocyte count positively correlated with BMD in the left hip (r = 0.34; p ≤ 0.05). Lymphocyte and monocyte counts correlated with BMD and BMD Z-scores in all measured areas (p ≤ 0.05).

Conclusion: Our study confirmed a positive relationship between hematopoiesis and bone metabolism disruption in patients with AN. The reduction in the number of osteoblasts, which create a supportive microenvironment for hematopoietic stem cells, leads to a reduction in all analysed blood cells. We hypothesize that a decrease in the number of osteoblasts and hematopoietic cells in patients with AN is associated with an increase in the amount of adipose tissue in the bone marrow. Further study is needed to confirm this hypothesis. Additionally, longitudinal studies should determine the effect of weight changes on hematopoiesis and bone metabolism.

Keywords:

Hematopoiesis – bone metabolism – bone mineral density – eating disorder


Zdroje

1. Smink FRE, Van Hoeken D, Oldehinkel AJ, Hoek HW. Prevalence and severity of DSM-5 eating disorders in a community cohort of adolescents. Int J Eat Disord 2014; 47: 610–619.

2. Association AP. Diagnostic and Statistical Manual of Dsm-5 TM. 2013.

3. Misra M, Aggarwal A, Miller KK, et al. Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community- dwelling adolescent girls. Pediatrics 2004; 114: 1574–1583.

4. Robinson L, Aldridge V, Clark EM, et al. A systematic review and meta-analysis of the association between eating disorders and bone density. Osteoporos Int 2016; 27: 1953–1966.

5. Čagalová A, Tichá Ľ, Killinger Z, Podracká Ľ. Vplyv mentálnej anorexie na kostný metabolizmus. Clin Osteol 2020; 25: 37–43.

6. Lorenzo J, Horowitz M, Choi Y. Osteoimmunology: Interactions of the bone and immune system. Endocr Rev 2008; 29: 403–440.

7. Visnjic D, Kalajzic Z, Rowe DW, et al. Hematopoiesis is severely altered in mice with an induced osteoblast deficiency. Blood 2004; 103: 3258–3264.

8. Cesari M, Pahor M, Lauretani F, et al. Bone density and hemoglobin levels in older persons: results from the InCHIANTI study. Osteoporos Int 2005; 16: 691–699.

9. Valderrábano RJ, Lui L-Y, Lee J, et al. Bone density loss is associated with blood cell counts. J Bone Miner Res 2017; 32: 212–220.

10. Polineni S, Resulaj M, Faje AT , et al. Red and white blood cell counts are associated with bone marrow adipose tissue, bone mineral density, and bone microarchitecture in premenopausal women. J Bone Miner Res 2020; 35: 1031–1039.

11. Practice T, Medicine R. Current evaluation of amenorrhea. Fertil Steril 2008; 90: S219–S225.

12. Regecová V, Hamade J, Janechová H, Ševčíková Ľ. Comparison of Slovak reference values for anthropometric parameters in children and adolescents with international growth standards: implications for the assessment of overweight and obesity. Croat Med J 2018; 59: 313–326.

13. Gordon CM, Leonard MB, Zemel BS; International Society for Clinical Densitometry. 2013 Pediatric Position Development Conference: Executive Summary and Reflections. J Clin Densitom 2014; 17: 219–224.

14. Soyka LA, Misra M, Frenchman A, et al. Abnormal bone mineral accrual in adolescent girls with anorexia nervosa. J Clin Endocrinol Metab 2002; 87: 4177–4185.

15. Tichá, Payer J, Killinger Z, Podracká. Porucha kostného metabolizmu pri mentálnej anorexii. Čes-Slov Pediatr 2016; 71: 287–292.

16. Čagalová A, Tichá Ľ, Gaál Kovalčíková A, et al. Bone mineral density and oxidative stress in adolescent girls with anorexia nervosa. Eur J Pediatr 2022; 181: 311–321.

17. Bredella MA, Fazeli PK, Miller KK, et al. Increased bone marrow fat in anorexia nervosa. J Clin Endocrinol Metab 2009; 94: 2129–2136.

18. Biver E, Salliot C, Combescure C, et al. Influence of adipokines and ghrelin on bone mineral density and fracture risk: a systematic review and meta-analysis. J Clin Endocrinol Metab 2011; 96: 2703–2713.

19. Legroux-Gerot I, Vignau J, Collier F, Cortet B. Bone loss associated with anorexia nervosa. Joint Bone Spine 2005; 72: 489–495.

20. Winther A, Jørgensen L, Ahmed LA, et al. Bone mineral density at the hip and its relation to fat mass and lean mass in adolescents: The Tromsø Study, Fit Futures. BMC Musculoskelet Disord. 2018. https: //doi. org/10.1186/s12891-018-1933-x.

21. Panaroni C, Tzeng YS , Saeed H, Wu JY. Mesenchymal progenitors and the osteoblast lineage in bone marrow hematopoietic niches. Curr Osteoporos Rep 2014; 12: 22–32.

22. Taichman RS, Emerson SG. Human osteoblasts support hematopoiesis through the production of granulocyte colony-stimulating factor. J Exp Med 1994; 179: 1677–1682.

23. Taichman RS, Emerson SG. Human osteosarcoma cell lines MG-63 and SaOS-2 produce G-CSF and GM-CSF: Identification and partial characterization of cell-associated isoforms. Exp Hematol 1996; 24: 509–517.

24. Nelissen JMDT, Torensma R, Pluyter M, et al. Molecular analysis of the hematopoiesis supporting osteoblastic cell line U2-OS. Exp Hematol 2000; 28: 422–32.

25. Aubin JE. Regulation of osteoblast formation and function. Rev Endocr Metab Disord 2001; 2: 81–94.

26. Moerman EJ, Teng K, Lipschitz DA, Lecka-Czernik B. Aging activates adipogenic and suppresses osteogenic programs in mesenchymal marrow stroma/stem cells: the role of PPAR -γ2 transcription factor and TGF-β/BMP signaling pathways. Aging Cell 2004; 3: 379–389.

27. Di Iorgi N, Rosol M, Mittelman SD, Gilsanz V. Reciprocal relation between marrow adiposity and the amount of bone in the axial and appendicular skeleton of young adults. J Clin Endocrinol Metab 2008; 93: 2281–2286.

28. Polineni S, Resulaj M, Faje AT , et al. Red and White Blood Cell Counts Are Associated With Bone Marrow Adipose Tissue, Bone Mineral Density, and Bone Microarchitecture in Premenopausal Women. J Bone Miner Res 2020; 35: 1031–1039.

Štítky
Neonatology Paediatrics General practitioner for children and adolescents
Prihlásenie
Zabudnuté heslo

Zadajte e-mailovú adresu, s ktorou ste vytvárali účet. Budú Vám na ňu zasielané informácie k nastaveniu nového hesla.

Prihlásenie

Nemáte účet?  Registrujte sa

#ADS_BOTTOM_SCRIPTS#