Relationship between intrahepatic lipids and bone mass in anorexia nervosa

• Grant number: 21/12262-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2021
• End date: October 31, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Francisco José Albuquerque de Paula
• Grantee: Maria Victória Figueiredo Rebolho
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
• Associated research grant: 18/18071-5 - Hydroelectrolytic and energy homeostasis: from cellular metabolism to endocrine systems in different phases of development, AP.TEM

Abstract

Anorexia nervosa (AN) is characterized by an individual's refusal, inability, or extreme aversion to keep his/her own body weight within normative limits, culminating in fasting self-imposition. It is a serious psychiatric disorder, with high morbidity and has become a psychiatric disease with the highest mortality rates. Fasting leads to severe weight loss, leading to the depletion of muscle mass and fat tissue. Due to the patient's starvation, the weakened organism develops metabolic adaptations to reduce energy expenditure while maintaining the supply of energy substrates for vital tissues. In this situation, there is impairment in fertility, growth, and bone mass. Decreased IGF1 and hypogonadism are two important factors for triggering one of the main complications of AN, osteoporosis. In addition, recent studies show that bone marrow fat is increased in AN and it has a negative relationship with bone mass. In this situation, other relevant aspect is the occurrence of liver changes. Malnutrition-induced hepatitis is common among individuals with AN, especially in conditions of abrupt body mass index decrease. Liver enzymes can also change due to consecutive refeeding. Studies show that liver changes can be negatively related to bone mass. This relationship has not yet been explored in individuals with anorexia nervosa. Thus, this work will aim to assess the interactions between the degree of hepatic steatosis, bone marrow adipose tissue and bone tissue in anorexia nervosa. Bone densitometry tests will be performed to determine bone mass, magnetic resonance imaging to assess bone marrow adipose tissue and biochemical tests to identify liver changes that may occur in AN. (AU)