Hematological alterations in adolescent girls with restrictive anorexia nervosa and secondary amenorrhea at the time of diagnosis
- 1Institute of Molecular Biomedicine, Faculty of Medicine, Comenius University, Bratislava, Slovakia
- 2Department of Pediatrics, Faculty of Medicine, National Institute of Children's Diseases, Comenius University, Bratislava, Slovakia
Abstract
Background: Anorexia nervosa (AN) is associated with chronic energy deficiency and endocrine adaptations affecting multiple organ systems involving bone metabolism and hematological homeostasis. However, early alterations in peripheral blood counts of adolescents with a clinically homogeneous AN phenotype remain insufficiently characterized.
Purpose: To examine the differences in blood counts and associated bone and endocrine parameters between adolescent girls with newly diagnosed restrictive AN and secondary amenorrhea and healthy age-matched controls.
Methods: The study included 59 patients and 20 controls. Hematological indices, anthropometric characteristics, body composition, bone mineral status, bone turnover, and endocrine status markers were compared, and a multivariate analysis was used to identify the predictors of blood counts.
Results: Compared to controls, patients had significantly lower leukocyte, erythrocyte, and platelet counts (all P<0.01), and 29% had cytopenia in at least one parameter. Bone formation markers (osteocalcin, amino-terminal propeptide of human procollagen type I, and alkaline phosphatase) and key endocrine parameters (insulin-like growth factor-1, estradiol, and free thyroxine) were suppressed. These alterations were also observed in patients with a normal bone mineral density and adequate vitamin B12 and folate levels. A multivariate analysis identified endocrine- and bone-related predictors of blood counts in controls but no consistent pattern of predictors in patients.
Conclusion: Adolescent girls with restrictive AN and secondary amenorrhea demonstrated hematological alterations at the time of diagnosis despite the absence of a measurable skeletal impairment or micronutrient deficiency These findings suggest that a chronic energy deficiency and endocrine adaptation are associated with early disturbances in hematological homeostasis. Peripheral blood count may represent an accessible clinical marker of systemic disturbances.
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BibTeX
@article{sebekova2026hematological,
title = {{Hematological alterations in adolescent girls with restrictive anorexia nervosa and secondary amenorrhea at the time of diagnosis}},
author = {Katarína Šebeková and Alexandra Gaál Kovalčíková and Ľubica Tichá and Ľudmila Podracká},
journal = {Clinical and Experimental Pediatrics},
year = {2026},
month = oct,
doi = {10.3345/cep.2026.00808},
url = {https://doi.org/10.3345/cep.2026.00808},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Hematological alterations in adolescent girls with restrictive anorexia nervosa and secondary amenorrhea at the time of diagnosis
AU - Katarína Šebeková
AU - Alexandra Gaál Kovalčíková
AU - Ľubica Tichá
AU - Ľudmila Podracká
PY - 2026
DA - 2026/10/19
JO - Clinical and Experimental Pediatrics
DO - 10.3345/cep.2026.00808
UR - https://doi.org/10.3345/cep.2026.00808
AB - Background: Anorexia nervosa (AN) is associated with chronic energy deficiency and endocrine adaptations affecting multiple organ systems involving bone metabolism and hematological homeostasis. However, early alterations in peripheral blood counts of adolescents with a clinically homogeneous AN phenotype remain insufficiently characterized. Purpose: To examine the differences in blood counts and associated bone and endocrine parameters between adolescent girls with newly diagnosed restrictive AN and secondary amenorrhea and healthy age-matched controls. Methods: The study included 59 patients and 20 controls. Hematological indices, anthropometric characteristics, body composition, bone mineral status, bone turnover, and endocrine status markers were compared, and a multivariate analysis was used to identify the predictors of blood counts. Results: Compared to controls, patients had significantly lower leukocyte, erythrocyte, and platelet counts (all P<0.01), and 29% had cytopenia in at least one parameter. Bone formation markers (osteocalcin, amino-terminal propeptide of human procollagen type I, and alkaline phosphatase) and key endocrine parameters (insulin-like growth factor-1, estradiol, and free thyroxine) were suppressed. These alterations were also observed in patients with a normal bone mineral density and adequate vitamin B12 and folate levels. A multivariate analysis identified endocrine- and bone-related predictors of blood counts in controls but no consistent pattern of predictors in patients. Conclusion: Adolescent girls with restrictive AN and secondary amenorrhea demonstrated hematological alterations at the time of diagnosis despite the absence of a measurable skeletal impairment or micronutrient deficiency These findings suggest that a chronic energy deficiency and endocrine adaptation are associated with early disturbances in hematological homeostasis. Peripheral blood count may represent an accessible clinical marker of systemic disturbances.
SN - 2713-4148
ER -