{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:04:25Z","timestamp":1791612265631,"version":"4.3.4"},"reference-count":49,"publisher":"The Endocrine Society","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"DOI":"10.1210\/jc.2018-00338","type":"journal-article","created":{"date-parts":[[2018,4,6]],"date-time":"2018-04-06T20:21:28Z","timestamp":1523046088000},"page":"2392-2402","source":"Crossref","is-referenced-by-count":28,"title":["Bone Parameters in Anorexia Nervosa and Athletic Amenorrhea: Comparison of Two Hypothalamic Amenorrhea States"],"prefix":"10.1210","volume":"103","author":[{"given":"Nurgun","family":"Kandemir","sequence":"first","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Slattery","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn E","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Divisions of Sports Medicine and Endocrinology, Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shreya","family":"Tulsiani","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amita","family":"Bose","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vibha","family":"Singhal","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charumathi","family":"Baskaran","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seda","family":"Ebrahimi","sequence":"additional","affiliation":[{"name":"Center of Eating Disorders Management, Cambridge, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Goldstein","sequence":"additional","affiliation":[{"name":"Division of Adolescent Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kamryn","family":"Eddy","sequence":"additional","affiliation":[{"name":"Eating Disorders Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Klibanski","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhusmita","family":"Misra","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"},{"name":"Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2018,4,5]]},"reference":[{"issue":"3","key":"key\n\t\t\t\t20180626061833_B1","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1542\/peds.86.3.440","article-title":"Decreased bone density in adolescent girls with anorexia nervosa","volume":"86","author":"Bachrach","year":"1990","journal-title":"Pediatrics"},{"issue":"9","key":"key\n\t\t\t\t20180626061833_B2","doi-asserted-by":"crossref","first-page":"4177","DOI":"10.1210\/jc.2001-011889","article-title":"Abnormal bone mineral accrual in adolescent girls with anorexia nervosa","volume":"87","author":"Soyka","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"key\n\t\t\t\t20180626061833_B3","doi-asserted-by":"crossref","first-page":"1365","DOI":"10.1097\/00004583-200011000-00010","article-title":"Predictors of bone mineral density reduction in adolescents with anorexia nervosa","volume":"39","author":"Castro","year":"2000","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"2","key":"key\n\t\t\t\t20180626061833_B4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1007\/s007870200011","article-title":"Bone mineral density in adolescent girls with anorexia nervosa--a cross-sectional study","volume":"11","author":"Jagielska","year":"2002","journal-title":"Eur Child Adolesc Psychiatry"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B5","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1542\/peds.2004-0540","article-title":"Effects of anorexia nervosa on clinical, hematologic, biochemical, and bone density parameters in community-dwelling adolescent girls","volume":"114","author":"Misra","year":"2004","journal-title":"Pediatrics"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B6","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.jadohealth.2006.09.011","article-title":"Bone changes in adolescent girls with anorexia nervosa","volume":"39","author":"Stone","year":"2006","journal-title":"J Adolesc Health"},{"issue":"1","key":"key\n\t\t\t\t20180626061833_B7","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.bone.2007.03.018","article-title":"Skeletal status and laboratory investigations in adolescent girls with anorexia nervosa","volume":"41","author":"O\u015bwiecimska","year":"2007","journal-title":"Bone"},{"issue":"5","key":"key\n\t\t\t\t20180626061833_B8","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1002\/eat.22248","article-title":"Fracture risk and areal bone mineral density in adolescent females with anorexia nervosa","volume":"47","author":"Faje","year":"2014","journal-title":"Int J Eat Disord"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B9","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1210\/jc.2007-1434","article-title":"Weight gain and restoration of menses as predictors of bone mineral density change in adolescent girls with anorexia nervosa-1","volume":"93","author":"Misra","year":"2008","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"key\n\t\t\t\t20180626061833_B10","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/j.bone.2009.09.005","article-title":"Hormone predictors of abnormal bone microarchitecture in women with anorexia nervosa","volume":"46","author":"Lawson","year":"2010","journal-title":"Bone"},{"issue":"5","key":"key\n\t\t\t\t20180626061833_B11","doi-asserted-by":"crossref","first-page":"1923","DOI":"10.1210\/jc.2012-4153","article-title":"Adolescent girls with anorexia nervosa have impaired cortical and trabecular microarchitecture and lower estimated bone strength at the distal radius","volume":"98","author":"Faje","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"key\n\t\t\t\t20180626061833_B12","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1148\/radiol.2492080173","article-title":"Distal radius in adolescent girls with anorexia nervosa: trabecular structure analysis with high-resolution flat-panel volume CT","volume":"249","author":"Bredella","year":"2008","journal-title":"Radiology"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B13","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1542\/peds.2007-2392","article-title":"Bone metabolism in adolescent athletes with amenorrhea, athletes with eumenorrhea, and control subjects","volume":"121","author":"Christo","year":"2008","journal-title":"Pediatrics"},{"issue":"8","key":"key\n\t\t\t\t20180626061833_B14","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1249\/MSS.0000000000000574","article-title":"Fractures in relation to menstrual status and bone parameters in young athletes","volume":"47","author":"Ackerman","year":"2015","journal-title":"Med Sci Sports Exerc"},{"issue":"10","key":"key\n\t\t\t\t20180626061833_B15","doi-asserted-by":"crossref","first-page":"3123","DOI":"10.1210\/jc.2011-1614","article-title":"Bone microarchitecture is impaired in adolescent amenorrheic athletes compared with eumenorrheic athletes and nonathletic controls","volume":"96","author":"Ackerman","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B16","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1016\/j.bone.2012.07.019","article-title":"Cortical microstructure and estimated bone strength in young amenorrheic athletes, eumenorrheic athletes and non-athletes","volume":"51","author":"Ackerman","year":"2012","journal-title":"Bone"},{"key":"key\n\t\t\t\t20180626061833_B17","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.bone.2015.06.021","article-title":"Altered trabecular bone morphology in adolescent and young adult athletes with menstrual dysfunction","volume":"81","author":"Mitchell","year":"2015","journal-title":"Bone"},{"issue":"2","key":"key\n\t\t\t\t20180626061833_B18","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1210\/jcem-68-2-301","article-title":"Neuroendocrine aberrations in women with functional hypothalamic amenorrhea","volume":"68","author":"Berga","year":"1989","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B19","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1056\/NEJMcp0912024","article-title":"Clinical practice. Functional hypothalamic amenorrhea","volume":"363","author":"Gordon","year":"2010","journal-title":"N Engl J Med"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B20","first-page":"1905","article-title":"Neuroendocrine abnormalities in hypothalamic amenorrhea: spectrum, stability, and response to neurotransmitter modulation","volume":"84","author":"Perkins","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"key":"key\n\t\t\t\t20180626061833_B21","first-page":"673","article-title":"Adolescent girls, the menstrual cycle, and bone health","volume":"16","author":"Adams Hillard","year":"2003","journal-title":"J Pediatr Endocrinol Metab"},{"issue":"9","key":"key\n\t\t\t\t20180626061833_B22","doi-asserted-by":"crossref","first-page":"652","DOI":"10.3109\/09513590.2010.486452","article-title":"Hypoestrogenism in young women and its influence on bone mass density","volume":"26","author":"Meczekalski","year":"2010","journal-title":"Gynecol Endocrinol"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B23","first-page":"2049","article-title":"Severity of osteopenia in estrogen-deficient women with anorexia nervosa and hypothalamic amenorrhea","volume":"84","author":"Grinspoon","year":"1999","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"key\n\t\t\t\t20180626061833_B24","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1210\/jcem-68-3-548","article-title":"Mechanisms of osteoporosis in adult and adolescent women with anorexia nervosa","volume":"68","author":"Biller","year":"1989","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"key\n\t\t\t\t20180626061833_B25","doi-asserted-by":"crossref","first-page":"4710","DOI":"10.1210\/jc.2009-1046","article-title":"Hypercortisolemia is associated with severity of bone loss and depression in hypothalamic amenorrhea and anorexia nervosa","volume":"94","author":"Lawson","year":"2009","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"key\n\t\t\t\t20180626061833_B26","doi-asserted-by":"crossref","first-page":"5615","DOI":"10.1210\/jc.2003-030532","article-title":"Alterations in growth hormone secretory dynamics in adolescent girls with anorexia nervosa and effects on bone metabolism","volume":"88","author":"Misra","year":"2003","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B27","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1210\/jc.2006-2501","article-title":"Androgens in women with anorexia nervosa and normal-weight women with hypothalamic amenorrhea","volume":"92","author":"Miller","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"key\n\t\t\t\t20180626061833_B28","first-page":"449","article-title":"Bone density at weight-bearing and nonweight-bearing sites in ballet dancers: the effects of exercise, hypogonadism, and body weight","volume":"78","author":"Young","year":"1994","journal-title":"J Clin Endocrinol Metab"},{"issue":"10","key":"key\n\t\t\t\t20180626061833_B29","doi-asserted-by":"crossref","first-page":"2430","DOI":"10.1002\/jbmr.447","article-title":"Physiologic estrogen replacement increases bone density in adolescent girls with anorexia nervosa","volume":"26","author":"Misra","year":"2011","journal-title":"J Bone Miner Res"},{"issue":"3","key":"key\n\t\t\t\t20180626061833_B30","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1016\/j.bone.2009.06.002","article-title":"Effects of rhIGF-1 administration on surrogate markers of bone turnover in adolescents with anorexia nervosa","volume":"45","author":"Misra","year":"2009","journal-title":"Bone"},{"key":"key\n\t\t\t\t20180626061833_B31","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"1994","edition":"4th ed"},{"key":"key\n\t\t\t\t20180626061833_B32","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"2013","edition":"5th ed"},{"key":"key\n\t\t\t\t20180626061833_B33","unstructured":"Kuczmarski RJ , OgdenCL, Grummer-StrawnLM, FlegalKM, GuoSS, WeiR, MeiZ, CurtinLR, RocheAF, JohnsonCL. CDC growth charts: United States. Adv Data. 2000;(314):1\u201327."},{"issue":"10","key":"key\n\t\t\t\t20180626061833_B34","doi-asserted-by":"crossref","first-page":"3160","DOI":"10.1210\/jc.2011-1111","article-title":"Revised reference curves for bone mineral content and areal bone mineral density according to age and sex for black and non-black children: results of the bone mineral density in childhood study","volume":"96","author":"Zemel","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B35","doi-asserted-by":"crossref","first-page":"e100218","DOI":"10.1371\/journal.pone.0100218","article-title":"Irisin levels are lower in young amenorrheic athletes compared with eumenorrheic athletes and non-athletes and are associated with bone density and strength estimates","volume":"9","author":"Singhal","year":"2014","journal-title":"PLoS One"},{"issue":"1","key":"key\n\t\t\t\t20180626061833_B36","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.jadohealth.2006.08.013","article-title":"Bone mineral density in postmenarchal adolescent girls in the United States: associated biopsychosocial variables and bone turnover markers","volume":"40","author":"Harel","year":"2007","journal-title":"J Adolesc Health"},{"issue":"3","key":"key\n\t\t\t\t20180626061833_B37","doi-asserted-by":"crossref","first-page":"696S","DOI":"10.1093\/jn\/134.3.696S","article-title":"Factors that affect bone mineral accrual in the adolescent growth spurt","volume":"134","author":"Whiting","year":"2004","journal-title":"J Nutr"},{"issue":"11","key":"key\n\t\t\t\t20180626061833_B38","doi-asserted-by":"crossref","first-page":"1001","DOI":"10.2165\/00007256-200737110-00006","article-title":"Bone density and young athletic women. An update","volume":"37","author":"Nichols","year":"2007","journal-title":"Sports Med"},{"issue":"2","key":"key\n\t\t\t\t20180626061833_B39","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1016\/S0278-5919(05)70201-5","article-title":"Bone health and osteoporosis","volume":"19","author":"Nichols","year":"2000","journal-title":"Clin Sports Med"},{"issue":"2","key":"key\n\t\t\t\t20180626061833_B40","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/jbmr.5650070204","article-title":"New approaches for interpreting projected bone densitometry data","volume":"7","author":"Carter","year":"1992","journal-title":"J Bone Miner Res"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B41","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1007\/s00330-002-1676-8","article-title":"Bone densitometry in children: a critical appraisal","volume":"13","author":"van Rijn","year":"2003","journal-title":"Eur Radiol"},{"issue":"1","key":"key\n\t\t\t\t20180626061833_B42","first-page":"37","article-title":"Effect of fat on measurement of bone mineral density","volume":"7","author":"Javed","year":"2009","journal-title":"Int J Body Compos Res"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B43","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jocd.2010.02.003","article-title":"Assessing bone microstructure at the distal radius in children and adolescents using HR-pQCT: a methodological pilot study","volume":"13","author":"Burrows","year":"2010","journal-title":"J Clin Densitom"},{"issue":"5","key":"key\n\t\t\t\t20180626061833_B44","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1210\/jc.2017-00131","article-title":"Functional hypothalamic amenorrhea: an Endocrine Society clinical practice guideline","volume":"102","author":"Gordon","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"key\n\t\t\t\t20180626061833_B45","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.jadohealth.2006.09.010","article-title":"Effects of an oral contraceptive (norgestimate\/ethinyl estradiol) on bone mineral density in adolescent females with anorexia nervosa: a double-blind, placebo-controlled study","volume":"39","author":"Strokosch","year":"2006","journal-title":"J Adolesc Health"},{"issue":"7","key":"key\n\t\t\t\t20180626061833_B46","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.metabol.2011.11.016","article-title":"The effect of gonadal and adrenal steroid therapy on skeletal health in adolescents and young women with anorexia nervosa","volume":"61","author":"Divasta","year":"2012","journal-title":"Metabolism"},{"issue":"7","key":"key\n\t\t\t\t20180626061833_B47","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1210\/jc.2011-0380","article-title":"Effects of risedronate and low-dose transdermal testosterone on bone mineral density in women with anorexia nervosa: a randomized, placebo-controlled study","volume":"96","author":"Miller","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"key\n\t\t\t\t20180626061833_B48","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1210\/jc.2013-4105","article-title":"Teriparatide increases bone formation and bone mineral density in adult women with anorexia nervosa","volume":"99","author":"Fazeli","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"key\n\t\t\t\t20180626061833_B49","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1249\/MSS.0b013e3182a03b8b","article-title":"Low bone density risk is higher in exercising women with multiple triad risk factors","volume":"46","author":"Gibbs","year":"2014","journal-title":"Med Sci Sports Exerc"}],"container-title":["The Journal of Clinical Endocrinology & Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/article-pdf\/103\/6\/2392\/25088580\/jc.2018-00338.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T12:13:45Z","timestamp":1660824825000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/103\/6\/2392\/4961061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,4,5]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2018,4,5]]},"published-print":{"date-parts":[[2018,6,1]]}},"URL":"https:\/\/doi.org\/10.1210\/jc.2018-00338","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,6]]},"published":{"date-parts":[[2018,4,5]]}}}