HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (Publish Ahead of Print[PDF]) All Versions of this Article: 89/4/1005    most recent ajcn.2008.26958v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Haas, V. K Articles by Gaskin, K. J Search for Related Content PubMed PubMed Citation Articles by Haas, V. K Articles by Gaskin, K. J Agricola Articles by Haas, V. K Articles by Gaskin, K. J

Body composition changes in female adolescents with anorexia nervosa^1,2,3

¹ From the Department of Gastroenterology, Charité University Hospital, Berlin, Germany (VKH); the Department of Adolescent Medicine (MRK), Psychological Medicine (SM), and the James Fairfax Institute of Paediatric Nutrition (KJG and JRA), The Children's Hospital at Westmead and the University of Sydney, Sydney, Australia; the Centre of Research into Adolescent's Health, Westmead Hospital, Sydney, Australia (SDC); and the Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Kiel, Germany (MJM).

² Supported by grants from the Centre of Research into Adolescent's Health (CRASH), Westmead Hospital and the James Fairfax Institute of Paediatric Nutrition, the Children's Hospital at Westmead, Sydney, Australia; and the DAAD, German Academic Exchange Service, Bonn, Germany.

³ Address reprint requests to MR Kohn, Department of Adolescent Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Australia. E-mail: michaek2{at}chw.edu.au. Address correspondence to VK Haas, Stoffwechsellabor, Medizinische Klinik mit Schwerpunkt Gastroenterologie, Hepatologie und Endokrinologie, Charitéplatz 1, 10117 Berlin, Germany. E-mail: verena.haas{at}charite.de.

ABSTRACT

Background: Body weight provides limited information about nutritional status of patients with anorexia nervosa (AN).

Objectives: Our objectives were to determine body composition (BC) changes, to find clinical predictors and endocrine correlates of total body protein (TBPr) depletion, and to compare results on fat mass (FM) obtained with anthropometry (skinfold measurements) and dual-energy X-ray absorptiometry (DXA) in patients with AN.

Design: Body weight, body mass index (BMI; in kg/m²), BC (with DXA and skinfold measurements), and TBPr [with in vivo neutron activation analysis (IVNAA)] was assessed in 50 AN patients (15.2 y) and 40 healthy sex- and age-matched controls. In 47 AN patients and 22 controls, hormone concentrations were measured.

Results: In AN patients, body weight (44.4 ± 5.5 kg), BMI (16.7 ± 1.6), and FM_DXA (7.0 ± 3.4 kg) were lower than in controls. Lean tissue mass by DXA (LTM_DXA) was similar in AN patients and controls (35.7 ± 4.3 compared with 35.8 ± 4.5 kg), but TBPr was 87% of that of controls (8.1 ± 1.0 compared with 9.2 ± 1.2 kg; P < 0.001). Cortisol was high, testosterone was unchanged, and estradiol and insulin-like growth factor I were low. Severe protein depletion measured by IVNAA seen in 17 AN patients could not be identified with simpler methods. All except 1 of 26 AN patients with a BMI > 16.5 had normal TBPr. The difference of individual percentage of body fat measured with DXA and skinfold measurements came up to 9%.

Conclusion: The severe protein depletion in 34% of AN patients was not accurately identified by LTM_DXA or simpler methods, but a BMI > 16.5 indicated normal TBPr. Future studies need to compare DXA and skinfold measurements with a reference technique to assess FM in AN patients.

Received for publication September 11, 2008. Accepted for publication December 14, 2008.