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J Clin Endocrinol Metab, 2015; (): jc20151011, PMID: 26086327

Reduced bone strength and muscle force in women 27 years after anorexia nervosa.

Year: 2015

Mueller SM, Immoos M, Anliker E, Drobnjak S, Boutellier U, Toigo M
Exercise Physiology Lab, Institute of Human Movement Sciences, ETH Zurich, Zurich, Switzerland;


CONTEXT: A substantial body of research findings indicate that muscle mass and bone mass are reduced in populations of anorexic females, even in such populations, whose anorexia nervosa had been in remission for longer periods. OBJECTIVE: This study aimed to investigate whether the bone of an anorexia nervosa recovery cohort is adapted to maximal muscle forces, and whether there are alterations in the structure of the tibia in this population, as compared to a control group. DESIGN, SETTING AND PARTICIPANTS: Cross-sectional study of twenty-two women in Switzerland, who have remained in stable recovery from anorexia nervosa for an average of 27 years. The measurements were compared to those of an age- and gender-matched control group (n = 73). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Bone characteristics of the tibia and maximal voluntary ground reaction force (Fm1LH). RESULTS: The variability in volumetric bone mineral content (vBMC) at the 14%-site was explained by 54.7% on the grounds of Fm1LH (P<0.001). Formerly anorexic women had an 11.6% lower Fm1LH (P=0.001), a significantly lower vBMC at 4% and 14% of tibia length, and an 11.9% (P=0.001) lower body mass than the age- and gender-matched control population. Present body mass of the anorexia group correlated positively with vBMC at the 14%-site (P<0.001). CONCLUSIONS: In spite of the fact that findings reflected an adaptation of bone to the acting forces, most results indicated that the test cohort generally suffered from a secondary bone defect. In addition, maximal muscle force was also impaired in the formerly anorexic women.

GID: 3929; Last update: 25.06.2015