J Castro1, L Lázaro, F Pons, I Halperin, J Toro. 1. Section of Child and Adolescent Psychiatry, Institute of Psychiatry and Psychology, Hospital Clínic Universitari, Barcelona, Spain. 16812jcf@comb.es
Abstract
OBJECTIVES: To determine which variables are associated with a significant reduction in bone mineral density (BMD) in adolescent anorexia nervosa and to establish guidelines for indication of bone densitometry. METHOD: One hundred seventy patients (treated from 1997 until 1999), aged 10 to 17 years, with a DSM-IV diagnosis of anorexia nervosa were evaluated by dual-energy-x-ray absorptiometry in the lumbar spine (L2-L4) and the femoral neck. The results were compared with the normative data for BMD values by age and sex in Spanish adolescents. RESULTS: 44.1% of patients had osteopenia at the lumbar spine and 24.7% at the femoral neck. The following variables were related to osteopenia: more than 12 months since onset of the disorder (p < .001), more than 6 months of amenorrhea (p < .001), body mass index <15 (p < .001), calcium intake <600 mg/day (p < .01), and <3 hours/week of physical activity (p < .001). In a stepwise logistic regression analysis to predict reduced spinal BMD, 3 variables-months elapsed since the onset of weight loss, calcium intake, and body mass index--correctly classified 78.8% of patients. CONCLUSIONS: Adolescent anorexia nervosa patients with the characteristics outlined above are at high risk of reduced BMD, and densitometry is recommended to determine the degree of osteopenia.
OBJECTIVES: To determine which variables are associated with a significant reduction in bone mineral density (BMD) in adolescent anorexia nervosa and to establish guidelines for indication of bone densitometry. METHOD: One hundred seventy patients (treated from 1997 until 1999), aged 10 to 17 years, with a DSM-IV diagnosis of anorexia nervosa were evaluated by dual-energy-x-ray absorptiometry in the lumbar spine (L2-L4) and the femoral neck. The results were compared with the normative data for BMD values by age and sex in Spanish adolescents. RESULTS: 44.1% of patients had osteopenia at the lumbar spine and 24.7% at the femoral neck. The following variables were related to osteopenia: more than 12 months since onset of the disorder (p < .001), more than 6 months of amenorrhea (p < .001), body mass index <15 (p < .001), calcium intake <600 mg/day (p < .01), and <3 hours/week of physical activity (p < .001). In a stepwise logistic regression analysis to predict reduced spinal BMD, 3 variables-months elapsed since the onset of weight loss, calcium intake, and body mass index--correctly classified 78.8% of patients. CONCLUSIONS:Adolescent anorexia nervosapatients with the characteristics outlined above are at high risk of reduced BMD, and densitometry is recommended to determine the degree of osteopenia.
Authors: J E Compston; C McConachie; C Stott; R A Hannon; S Kaptoge; I Debiram; S Love; A Jaffa Journal: Osteoporos Int Date: 2005-05-12 Impact factor: 4.507
Authors: Madhusmita Misra; Patrika Tsai; Ellen J Anderson; Jane L Hubbard; Katie Gallagher; Leslie A Soyka; Karen K Miller; David B Herzog; Anne Klibanski Journal: Am J Clin Nutr Date: 2006-10 Impact factor: 7.045
Authors: Madhusmita Misra; Marie Le Clair; Nara Mendes; Karen K Miller; Elizabeth Lawson; Erinne Meenaghan; Thomas Weigel; Seda Ebrahimi; David B Herzog; Anne Klibanski Journal: CNS Spectr Date: 2010-09 Impact factor: 3.790