Serum FGF-21 levels are associated with worsened radial trabecular bone microarchitecture and decreased radial bone strength in women with anorexia nervosa.

Abstract

BACKGROUND:

Anorexia 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 METHODS:

We 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.

RESULTS:

FGF-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.

CONCLUSIONS:

FGF-21 may be an important determinant of trabecular skeletal homeostasis in AN.

• Authors: Pouneh K Fazeli, Alexander T Faje, Ela J Cross, Hang Lee, Clifford J Rosen, Mary L Bouxsein, Anne Klibanski
• Journal: Bone (Bone) Vol. 77 Pg. 6-11 (Aug 2015) ISSN: 1873-2763 [Electronic] United States
• PMID: 25868802 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Chemical References

• fibroblast growth factor 21
• Fibroblast Growth Factors

Topics

• Absorptiometry, Photon
• Adult
• Anorexia Nervosa (blood, physiopathology)
• Bone Remodeling
• Bone and Bones (diagnostic imaging, physiopathology, ultrastructure)
• Case-Control Studies
• Female
• Fibroblast Growth Factors (blood)
• Finite Element Analysis
• Humans