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Bone mineral density at extremely low weight in patients with anorexia nervosa

2021; Wiley; Volume: 95; Issue: 3 Linguagem: Inglês

10.1111/cen.14498

1365-2265

P. Bemer, Laura Di Lodovico, Ohanyan Haykanush, Hélène Théodon, Karine Briot, Robert Carlier, M. Dicembre, M. Duquesnoy, Jean‐Claude Melchior, Mouna Hanachi,

Vitamin D Research Studies

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.Retrospective cohort study.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.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).Extremely severe patients with AN have high prevalence of low BMD, predicted by severity and chronicity of malnutrition.