Bone metabolism in patients with anorexia nervosa and amenorrhoea

  • L. IdolazziEmail author
  • M. El Ghoch
  • R. Dalle Grave
  • P. V. Bazzani
  • S. Calugi
  • S. Fassio
  • C. Caimmi
  • O. Viapiana
  • F. Bertoldo
  • V. Braga
  • M. Rossini
  • D. Gatti
Original Article



Aim of this study is focusing on bone metabolism in AN patients with amenorrhoea and related estrogen deficiency effects.


AN patients were compared both with healthy females and with postmenopausal women (reference model for estrogen deficiency). The study sample included 81 females with AN. Laboratory tests [25-OH vitamin D, bone turnover markers, intact parathyroid hormone, sclerostin (SOST) and dickkopf-related protein (DKK1)] and dual energy X-ray absorptiometry (DXA) were taken into account.


AN patients had higher levels of C-terminal telopeptide of type I collagen (CTX) than both control groups. AN adolescents had CTX higher than AN young adults. In postmenopausal women, intact N-propeptide of type I collagen was higher if compared with each other group. In AN groups, Dickkopf-related protein 1 was significantly lower than the two control groups. No differences were found in sclerostin except in adolescents. In AN adolescents, DXA values at femoral sites were higher than in AN young adults and a positive correlation was found with body weight (p < 0.01) and with fat mass evaluated using DXA (p < 0.01).


AN women with amenorrhoea have an increased bone resorption like postmenopausal women but bone formation is depressed. The consequent remodeling uncoupling is considerably more severe than that occurring after menopause.


Anorexia nervosa DKK-1 Sclerostin Bone turnover markers Body composition 



We thank Caterina Fraccarollo for the ELISA assays.

Compliance with ethical standards

Conflict of interest

Viapiana O has received speaking fees from Abiogen, Amgen, Merck Sharp & Dohme Corp. Idolazzi L has received speaking fees from Eli Lilly, UCB, Abbvie, Novartis. Fassio A declares he has no conflict of interests. Caimmi C declares he has no conflict of interests. Rossini M has received speaking and consulting fees from Abiogen, Amgen, Eli-Lilly and Merck Sharp & Dohme Corp. Davide Gatti has received speaking fees from Abiogen, Amgen, Eli-Lilly and Neopharmed-Gentili. El Ghoch M, Dalle Grave R, Bazzani PV, Calugi S, Bertoldo F, Braga V declare they have no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • L. Idolazzi
    • 1
    Email author
  • M. El Ghoch
    • 2
  • R. Dalle Grave
    • 2
  • P. V. Bazzani
    • 2
  • S. Calugi
    • 2
  • S. Fassio
    • 1
  • C. Caimmi
    • 1
  • O. Viapiana
    • 1
  • F. Bertoldo
    • 3
  • V. Braga
    • 1
  • M. Rossini
    • 1
  • D. Gatti
    • 1
  1. 1.Unit of RheumatologyUniversity of VeronaVeronaItaly
  2. 2.Department of Eating and Weight DisordersVilla Garda HospitalVeronaItaly
  3. 3.Internal MedicineUniversity of VeronaVeronaItaly

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