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Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study

OBJECTIVE: Children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD) often lose weight. It is important to understand the implications of this during growth. This prospective study was designed to quantify the changes in body composition and markers of bone metab...

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Autores principales: Poulton, Alison, Briody, Julie, McCorquodale, Thomas, Melzer, Elaine, Herrmann, Markus, Baur, Louise A, Duque, Gustavo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549744/
https://www.ncbi.nlm.nih.gov/pubmed/23216890
http://dx.doi.org/10.1186/1687-9856-2012-30
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author Poulton, Alison
Briody, Julie
McCorquodale, Thomas
Melzer, Elaine
Herrmann, Markus
Baur, Louise A
Duque, Gustavo
author_facet Poulton, Alison
Briody, Julie
McCorquodale, Thomas
Melzer, Elaine
Herrmann, Markus
Baur, Louise A
Duque, Gustavo
author_sort Poulton, Alison
collection PubMed
description OBJECTIVE: Children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD) often lose weight. It is important to understand the implications of this during growth. This prospective study was designed to quantify the changes in body composition and markers of bone metabolism on starting treatment. METHODS: 34 children (29 boys) aged 4.7 to 9.1 years newly diagnosed with ADHD were treated with dexamphetamine or methylphenidate, titrating the dose to optimise the therapeutic response. Medication was continued for as long as clinically indicated. Body composition and bone density (dual-energy X-ray absorptiometry) were measured at baseline, 6 months and 3 years; changes were analysed in Z-scores based on data from 241 healthy, local children. Markers of bone turnover were measured at baseline, 3 months and 3 years. RESULTS: Fat loss of 1.4±0.96kg (total fat 5.7±3.6 to 4.3±3.1kg, p<0.001) occurred in the first 6 months. There were significant reductions over 3 years in the sex and height corrected Z-scores for lean tissue, bone mineral content, bone mineral density and ratio of central to total fat (−0.84±0.86, p=0.003; -0.55±0.31, p<0.0001; -0.41±0.28, p<0.0001 and −0.55±0.62, p=0.006 respectively). Propeptide of type I collagen indicated a significant reduction in bone turnover after 3 months (564±202 to 458±96ng/ml, p=0.019), which was fully recovered after 3 years (619±276ng/ml). CONCLUSIONS: Stimulant medication was associated with early fat loss and reduced bone turnover. Lean tissue including bone increased more slowly over 3 years of continuous treatment than would be expected for growth in height. There was long-term improvement in the proportion of central fat for height. This study shows that relatively minor reductions in weight on stimulant medication can be associated with long-term changes in body composition. Further study is required to determine the effects of these changes on adult health.
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spelling pubmed-35497442013-01-23 Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study Poulton, Alison Briody, Julie McCorquodale, Thomas Melzer, Elaine Herrmann, Markus Baur, Louise A Duque, Gustavo Int J Pediatr Endocrinol Research OBJECTIVE: Children treated with stimulant medication for attention deficit hyperactivity disorder (ADHD) often lose weight. It is important to understand the implications of this during growth. This prospective study was designed to quantify the changes in body composition and markers of bone metabolism on starting treatment. METHODS: 34 children (29 boys) aged 4.7 to 9.1 years newly diagnosed with ADHD were treated with dexamphetamine or methylphenidate, titrating the dose to optimise the therapeutic response. Medication was continued for as long as clinically indicated. Body composition and bone density (dual-energy X-ray absorptiometry) were measured at baseline, 6 months and 3 years; changes were analysed in Z-scores based on data from 241 healthy, local children. Markers of bone turnover were measured at baseline, 3 months and 3 years. RESULTS: Fat loss of 1.4±0.96kg (total fat 5.7±3.6 to 4.3±3.1kg, p<0.001) occurred in the first 6 months. There were significant reductions over 3 years in the sex and height corrected Z-scores for lean tissue, bone mineral content, bone mineral density and ratio of central to total fat (−0.84±0.86, p=0.003; -0.55±0.31, p<0.0001; -0.41±0.28, p<0.0001 and −0.55±0.62, p=0.006 respectively). Propeptide of type I collagen indicated a significant reduction in bone turnover after 3 months (564±202 to 458±96ng/ml, p=0.019), which was fully recovered after 3 years (619±276ng/ml). CONCLUSIONS: Stimulant medication was associated with early fat loss and reduced bone turnover. Lean tissue including bone increased more slowly over 3 years of continuous treatment than would be expected for growth in height. There was long-term improvement in the proportion of central fat for height. This study shows that relatively minor reductions in weight on stimulant medication can be associated with long-term changes in body composition. Further study is required to determine the effects of these changes on adult health. BioMed Central 2012 2012-12-05 /pmc/articles/PMC3549744/ /pubmed/23216890 http://dx.doi.org/10.1186/1687-9856-2012-30 Text en Copyright ©2012 Poulton et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Poulton, Alison
Briody, Julie
McCorquodale, Thomas
Melzer, Elaine
Herrmann, Markus
Baur, Louise A
Duque, Gustavo
Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study
title Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study
title_full Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study
title_fullStr Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study
title_full_unstemmed Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study
title_short Weight loss on stimulant medication: how does it affect body composition and bone metabolism? – A prospective longitudinal study
title_sort weight loss on stimulant medication: how does it affect body composition and bone metabolism? – a prospective longitudinal study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549744/
https://www.ncbi.nlm.nih.gov/pubmed/23216890
http://dx.doi.org/10.1186/1687-9856-2012-30
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