Serum FGF-21 levels are associated with worsened radial trabecular bone microarchitecture and decreased radial bone strength in women with anorexia nervosa |
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| Affiliation: | 1. Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;2. Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA;3. Maine Medical Center Research Institute, Scarborough, ME, USA;4. Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA;1. Department of Medicine, Endocrine Unit, Massachusetts General Hospital, Boston, MA, United States;2. Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, United States;1. Centre for Energy and Environmental Sustainability, Lucknow 226 029, India;2. Department of Chemical and Biological Engineering, Korea University, 145, Anam-ro, Seongbuk-gu, Seoul 02841, Republic of Korea;3. Department of Environmental Engineering and Water Technology, IHE-Delft Institite for Water Education, 2601DA Delft, the Netherlands;1. Center for Applied Biomechanics, University of Virginia, Charlottesville, VA, USA;2. Human Systems Department, Naval Air Warfare Center Aircraft Division, Patuxent River, MD, USA;1. California Pacific Medical Center Research Institute, USA;2. Optasia Medical, UK;3. Park Nicollet Institute for Research and Education, Division of Health Policy and Management, University of Minnesota, USA;4. University of California San Francisco, USA;5. Oregon Health and Science University, USA;6. University of California San Diego, USA;7. Minneapolis VA Health System and University of Minnesota, USA |
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| Abstract: | BackgroundAnorexia nervosa (AN) is a psychiatric disorder characterized by self-induced starvation and low body weight. Women with AN have impaired bone formation, low bone mass and an increased risk of fracture. FGF-21 is a hormone secreted by the liver in starvation and FGF-21 transgenic mice have significant bone loss due to an uncoupling of bone resorption and bone formation. We hypothesized that FGF-21 may contribute to the low bone mass state of AN.Subjects and methodsWe studied 46 women: 20 with AN (median age [interquartile range]: 27.5 [25, 30.75] years) and 26 normal-weight controls (NWC) of similar age (25 [24, 28.5] years). We investigated associations between serum FGF-21 and 1) aBMD measured by dual energy X-ray absorptiometry, 2) parameters of bone microarchitecture in the distal radius and tibia measured by high-resolution peripheral quantitative CT and 3) bone strength, estimated by microfinite element analysis.ResultsFGF-21 levels were similar in AN and NWC (AN: 33.1 [18.1, 117.0] pg/ml vs. NWC: 57.4 [23.8, 107.1] pg/ml; p = 0.54). There was a significant inverse association between log FGF-21 and trabecular number in the radius in both AN (R = − 0.57, p < 0.01) and NWC (R = − 0.53, p < 0.01) and a significant positive association between log FGF-21 and trabecular separation in the radius in AN (R = 0.50, p < 0.03) and NWC (R = 0.52, p < 0.01). Estimates of radial bone strength were inversely associated with log FGF-21 in AN (R = − 0.50, p < 0.03 for both stiffness and failure load). There were no associations between FGF-21 and aBMD, cortical parameters or tibial parameters in the AN or NWC groups.ConclusionsFGF-21 may be an important determinant of trabecular skeletal homeostasis in AN. |
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