Background
Aims
Hypotheses
Expectations
Methods
Main Study
Participants
Main study/sample 1 (n = 52)
|
mean
|
SD
|
min
|
max
|
---|---|---|---|---|
Follow-up period (years) | 5.23 | 1.69 | 3 | 9 |
Age (t1/years)
| 15.51 | 2.07 | 9.83 | 18.83 |
Age (t2/years)
| 20.78 | 2.72 | 12.80 | 26.70 |
BMI (t1)
| 14.74 | 1.88 | 10.42 | 18.67 |
BMI (t2)
| 20.13 | 2.79 | 14.26 | 28.14 |
Sub study/sample 2 (n = 39)
|
mean
|
SD
|
min
|
max
|
Follow-up period (years)
| 5.26 | 1.71 | 3 | 9 |
Age (t1/years)
| 15.47 | 2.10 | 9.83 | 18.83 |
Age (t2/years)
| 20.72 | 2.79 | 12.80 | 25.50 |
BMI (t1)
| 14.88 | 1.86 | 14.87 | 18.67 |
BMI (t2)
| 19.91 | 2.52 | 14.30 | 26.30 |
Procedures
Outcome
|
n
(%)
|
BMI U1
(kg/m
2
) |
BMI U2
(kg/m
2
) |
amenorrhea
(months)
|
---|---|---|---|---|
Good
(BMI ≥17.5; regular menstrual cycle) | 26 (50.0%) | 14.9 (± 1.9) | 20.5 (± 2.2) | 13 (± 15) |
Intermediate
(BMI < 17.5 or BMI > 26; or irregular menstrual cycle/fluctuations of weight, amenorrhea) | 20 (38.5%) | 15.1 (± 1.9) | 20.6 (± 3.0) | 32 (± 27) |
Poor
(BMI < 17.5; amenorrhea; bulimic symptoms) | 6 (11.5%) | 13.1 (± 1.9) | 17.1 (± 2.6) | 27 (± 16) |
Instruments
Physical examination
Laboratory tests
Bone and lean body mass parameters
Analysis
Substudy
Participants
Nutritionally dependent hormones
Analysis
Results
Main study
General outcome of AN
Individual Person
|
Follow-up period
years
|
Age (t2)
(years)
|
BMI (t1)
(kg/m
2
) |
BMI (t2)
(kg/m
2
) |
amenorrhea
(months)
|
Binging/purging
| ||||
---|---|---|---|---|---|---|---|---|---|---|
A
| 4 | 19.5 | 14.5 | 16.4 | 14 | yes | ||||
B
| 3 | 20.6 | 10.8 | 22.1 | 24 | yes | ||||
C
| 4 | 19.5 | 12.8 | 16.6 | 36* | no | ||||
D
| 4 | 20.3 | 12.5 | 14.3 | 32* | no | ||||
E
| 3 | 19.5 | 13.9 | 17.0 | 4* | no | ||||
F
| 7 | 21.7 | 14.4 | 16.5 | 50 | yes |
Physical examination
Laboratory tests
Bone and lean body mass parameters
Parameter | t 1 | t 2 |
---|---|---|
Fat Body Mass (FBM) (%)
| 12 (± 7) | 25 (± 8)* |
Lean Body Mass (kg)
| 34 (± 5) | 39 (± 4)* |
Bone Mineral Content (kg)
| 2.04 (± 0.34) | 2.37 (± 0.32)* |
Bone Mineral Density (g/cm
2
)
| 1.04 (± 0.08) | 1.09 (± 0.07)* |
Outcome
|
good
n = 26
|
intermediate
n = 20
|
poor
n = 6
|
---|---|---|---|
BMI (kg/m
2
)
| 20.5 (± 2.2) | 20.6 (± 3.0) | 17.1 (± 2.6) |
FBM (%)
| 27 (± 8)** p < 0.001 (+) | 25 (± 8)** p < 0.001 (+) | 19 (± 7)* p = 0.021 (+) |
Δ FBM (Mean/SD)
| 0.13 (± 0.10) | 0.11(± 0.07) | 0.12 (± 0.10) |
LBM (kg)
| 39 (± 5)** p < 0.001 (+) | 39 (± 3)* p = 0.001 (+) | 36 (± 4) p = 0.062 (+) |
Δ LBM (Mean/SD)
| 4.94 (± 6.5) | 3.90 (± 3.48) | 4.27 (± 4.28) |
BMD (g/cm
2
)
| 1.10 (± 0.07)** p = 0.000 (+) | 1.09 (± 0.06) p = 0.050 (+) | 1.02 (± 0.08) p = 0.125 (-) |
Δ BMD (Mean/SD)
| 0.08 (± 0.07) | 0.02 (± 0.05) | -0.03 (± 0.04) |
BMC (kg)
| 2.43 (± 0.30)** p < 0.001 (+) | 2.38 (± 0.3)** p < 0.001 (+) | 2.04 (± 0.3) p = 0.872 (+) |
Δ BMC (Mean/SD)
| 0.08 (± 0.07) | 0.02 (± 0.05) | -0.05 (± 0.04) |
BMC/LBM (at follow-up)
| 0.062 (± 0.008) p = 0.15 | 0.060 (± 0.007) p = 0.53 | 0.054 (± 0.004)* p < 0.05 |
Δ BMC/LBM (Mean/SD)
| -0.003 (± 0.008) | -0.001 (± 0.008) | +0.007 (± 0.004) |
Outcome BMC z-core according to the outcome | Good M = .399 | Intermediate M = .166 | Poor M = .166 |
---|---|---|---|
Good
| 0.32 | 0.02 | |
Intermediate
| 0.32 | 0,11 | |
Poor
| 0.02 | 0.11 |
Physical activity
Hormone replacement
BMD
(g/cm
3
)
|
BMC
(kg)
|
LBM
(kg)
|
FBM
(%)
| |
---|---|---|---|---|
Hormone replacement
| 1.10 (± 0.06) p < 0.001 (+) | 2.40 (± 0.3) p < 0.001(+) | 39 (± 5) p < 0.001(+) | 26 (± 9) p < 0.001(+) |
Without substitution
| 1.06 (± 0.07) p = 0.028 (+) | 2.31 (± 0.4) p = 0.001 (+) | 39 (± 4) p < 0.001(+) | 25 (± 6) p < 0.001(+) |
p-level
| 0.06 | 0.33 | 0.96 | 0.65 |
Correlations
Substudy
General outcome of AN
Nutritionally dependent hormones
Good
(n = 20)
|
intermediate
(n = 15)
|
poor
(n = 4)
|
X
2
(df = 2)
|
p
| |
---|---|---|---|---|---|
BMI (kg/m
2
)
| 20,16 (± 2.10) | 20,26 (± 2.10) | 17.34 (± 3.37) | 3.97 | 0.14 |
BMD (g/cm
2
)
| 1,10 (± ,071) | 1,08 (± ,059) | 0.99 (± 0.02) | 7.27 | 0.03* |
BMC (kg)
| 2.37 (± 0.31) | 2,35 (± 0,32) | 1.92 (± 0.14) | 7.28 | 0.03* |
FBM (%)
| 26.85 (± 7.64) | 22.76 (± 7.46) | 19.53 (± 8.61) | 3.64 | 0.16 |
LBM
(kg)
| 38,28 (± 4,97) | 39,16 (± 3,93) | 35,37 (± 3,93) | 3,47 | 0.18 |
Leptin (μg/l)
| 12,36 (± 12,44) | 5,37 (± 2,63) | 12.40 (± 20.48) | 3.54 | 0.17 |
IGF-I (μg/l)
| 216,45 (± 80,63) | 223,07 (± 71,09) | 119.75 (± 37.77) | 7.72 | 0.02* |
Correlations
Leptin | IGF-I | FBM | LBM | BMI | BMC | |
---|---|---|---|---|---|---|
age (t2)
| -0.30 |
-0.42**
| ||||
BMI (body mass index) |
0.62**
| -0.08 |
0.47**
|
0.52**
| ||
FBM (fat body mass) |
0.85**
| -0.12 |
0.68**
|
0.49**
| ||
LBM (lean body mass) | 0.21 | 0.15 |
0.47**
|
0.60**
| ||
BMC (bone mineral content) |
0.35*
| 0.11 |
0.60**
|
0.52**
| ||
BMD (bone mineral density) | 0.15 | 0.28 |
0.36*
|
0.73*
| ||
IGF-I
| - 0.04 | 1.00 | ||||
Glucose
|
0.48**
| -0.15 |
0.54**
|
0.35*
|
0.42**
|