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TRAP 5a is a biomarker of chronic inflammation and influences adipose tissue and 5b associates with bone metabolism\/pathologies. The aim was to investigate the association of serum TRAP 5a\/5b isoforms with fat and bone markers and anthropometric parameters in patients with anorexia nervosa (AN) during weight gain therapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Twenty-five Swedish female AN patients, age 16\u201324\u00a0years, were treated for 12\u00a0weeks with a high-energy diet with six meals daily. Serum TRAP 5a\/5b, markers of fat\/glucose metabolism, markers of bone resorption and formation were measured. Parameters of bone and body composition were assessed by dual-energy X-ray absorptiometry and peripheral quantitative computed tomography.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>BMI increased from median 15.4\u00a0kg\/m<jats:sup>2<\/jats:sup> to 19.0\u00a0kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001. TRAP 5a and 5a\/5b ratio increased but TRAP 5b decreased during the study. TRAP \u03945a and \u03945b correlated with \u0394insulin and \u0394adiponectin, respectively. TRAP 5b correlated with trabecular density at start but not at week 12. At 12\u00a0weeks, TRAP 5b correlated with CTX, and \u0394 decrease in TRAP 5b correlated to \u0394 increase in bone-specific alkaline phosphatase.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>This clinical interventional study resulted in increased BMI in patients with AN. The decreased TRAP 5b protein levels confirm a role for TRAP 5b as a marker of bone resorption, whereas increased TRAP 5a seemed to derive from systemic changes in bone as well as metabolic changes. The combined detection of TRAP 5a and TRAP 5b in serum could be an indicator of improved bone metabolism.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Level of evidence<\/jats:title>\n<jats:p>Level III, prospective interventional cohort study.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s40519-019-00776-8","type":"journal-article","created":{"date-parts":[[2019,9,17]],"date-time":"2019-09-17T11:04:04Z","timestamp":1568718244000},"page":"1387-1397","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intensive weight gain therapy in patients with anorexia nervosa results in improved serum tartrate-resistant acid phosphatase (TRAP) 5a and 5b isoform protein levels"],"prefix":"10.1007","volume":"25","author":[{"given":"Christina","family":"Patlaka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bojan","family":"Tubic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3605-4014","authenticated-orcid":false,"given":"Pernilla","family":"L\u00e5ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Staffan","family":"Paulie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9633-6673","authenticated-orcid":false,"given":"Diana","family":"Swolin-Eide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2123-7838","authenticated-orcid":false,"given":"Per","family":"Magnusson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6ran","family":"Andersson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2019,9,17]]},"reference":[{"key":"776_CR1","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1192\/bjp.bp.107.048686","volume":"194","author":"E Wentz","year":"2009","unstructured":"Wentz E, Gillberg IC, Anckarsater H, Gillberg C, Rastam M (2009) Adolescent-onset anorexia nervosa: 18-year outcome. 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