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Bone mineral density at extremely low weight in patients with anorexia nervosa
Author(s) -
Bemer Pauline,
Di Lodovico Laura,
Haykanush Ohanyan,
Théodon Hélène,
Briot Karine,
Carlier Robert,
Dicembre Marika,
Duquesnoy Maéva,
Melchior JeanClaude,
Hanachi Mouna
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14498
Subject(s) - medicine , femoral neck , bone mineral , anorexia nervosa , cohort , bone density , retrospective cohort study , osteoporosis , dual energy x ray absorptiometry , eating disorders , psychiatry
Objective Low bone mineral density (BMD) is a frequent and invalidating consequence of chronic undernourishment in patients with anorexia nervosa (AN). The aim of this study was to assess prevalence and clinic‐biological correlates of low BMD and fractures in extremely undernourished inpatients with AN. Design Retrospective cohort study. Patients and measurements This study included 97 extremely malnourished female inpatients with AN consecutively admitted over 2 years. Clinical‐biological variables, history of fractures and BMD by dual‐energy X‐ray absorptiometry (DXA) were examined to find predictors of low BMD and fractures. Results The prevalence of low BMD was of 51% for lumbar spine and 38% for femoral neck. Z‐scores were lower at lumbar spine (−2.2 ± 1.2 SD) than at femoral neck (−1.9 ± 0.9 SD) ( P <.01). Fragility fractures were reported by 10% of patients. BMD was mainly predicted by FFM, illness duration, age at onset and restricting AN ( P <.05). Fractures were predicted by sodium concentrations, femoral neck Z‐score and illness duration ( P <.03). Conclusion Extremely severe patients with AN have high prevalence of low BMD, predicted by severity and chronicity of malnutrition.