Bone densitometry findings and prevalence of osteoporosis at initial scanning in girls with anorexia nervosa
Authors' conclusion
Girls with AN exhibit significant bone density deficit at initial screening, particularly at trabecular sites, alongside reduced muscle and fat mass. However, osteoporosis as per current ISCD criteria is rare.
Study context
- Population
- Girls with anorexia nervosa (AN) aged 10.2–19.8 years referred for initial DXA and peripheral quantitative computed tomography (pQCT) scans at a tertiary pediatric bone densitometry service, March 2013 to October 2022median age 15.5 years
- Participants
- 264 participants
- Exposure
- Bone densitometry by menstrual/pubertal status
- Secondary amenorrhean = 144
- Outcome
- Prevalence of osteoporosis per International Society for Clinical Densitometry (ISCD) criteria (VF, or clinically significant fracture history and BMD Z-score ≤ −2.0) at initial scanning
- Follow-up
- Initial scanning
Methodological detailsretrospective review, single tertiary paediatric bone densitometry service
- Retrospective review
- Single tertiary paediatric bone densitometry service
Main finding
As reported in the abstract
Mild single vertebral fractures (VFs), all meeting osteoporosis criteria due to VFs, none with low bone mineral density (BMD)
1%
n = 3
Osteoporosis based on fracture history and low BMD
0
Observational data: associations, not effects.
Further findings
Low BMD (lumbar spine bone mineral apparent density (BMAD) or total body less head BMD Z-score ≤ −2.0)
- Low BMD
- 18.9% (n = 50/264)
Densitometry parameters vs zero
- Significantly lower than zero, greater deficits at trabecular-rich sites
- P < 0.05
BMD parameters by menstrual status
- BMD, particularly total body less head BMD Z-score, better preserved in secondary amenorrhea vs normal and delayed puberty
- P < 0.05
Anthropometry SDS
- Height SDS, mean (SD)
- 0.1 (1.0)
- Weight SDS, significantly reduced (p < 0.001)
- −0.8 (1.1)
- BMI SDS, significantly reduced (p < 0.001)
- −0.9 (1.1)
pQCT areas for height
- Muscle area for height (reduced)
- −2.4 [0.9]
- Fat area for height (reduced)
- −0.9 [1.0]
- Bone area for height (increased)
- 2.5 [1.4]
Self-reported long bone fractures
- Any long bone fracture
- 16.7% (n = 44)
- Two fractures
- 3% (n = 8)
Original publication
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