Carla Caffarelli1, Antonella Al Refaie2, Michela De Vita2, Maria Dea Tomai Pitinca2, Arianna Goracci3, Andrea Fagiolini3, Stefano Gonnelli2. 1. Division of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy. carlacaffarelli@yahoo.it. 2. Division of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy. 3. Division of Psychiatry, Department of Molecular Medicine, University of Siena, Siena, Italy.
Abstract
PURPOSE: Reduced bone mineral density (BMD) and increase risk of fragility fracture are common complication of anorexia nervosa (AN). BMD by dual-energy X-ray absorptiometry (DXA) present several limits in subjects with AN. This study aimed to evaluate the usefulness of the new Radiofrequency echographic multispectrometry (REMS) technique in the assessment of bone status in young women with AN. METHODS: In a cohort of 50 subjects with restrictive AN and in 30 healthy controls, we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using both DXA and REMS technique. RESULTS: BMD evaluated by DXA and REMS technique at all measurement sites were all significantly (p < 0.01) lower in subjects suffering from AN subjects than in controls. Good correlations were detected between BMD by DXA and BMD by REMS measurements at LS (r = 0.64, p < 0.01) at FN (r = 0.86, p < 0.01) and at TH (r = 0.84, p < 0.01) in subjects suffering from AN. Moreover, Bland-Altman analysis confirmed the good agreement between the two techniques. The subjects suffering from AN with previous vertebral fragility fractures presented lower values of both BMD-LS and BMD-TH by DXA and by REMS with respect to those without fractures; however, the difference was significant only for BMD-TH by REMS (p < 0.05). CONCLUSIONS: Our data suggest that REMS technique due to its characteristic of precision and reproducibility may represent an important tool for the evaluation of the changes in bone status in AN young women, especially during the fertile age and in case of pregnancy and breastfeeding. LEVEL OF EVIDENCE: Level of evidence: level III cohort study.
PURPOSE: Reduced bone mineral density (BMD) and increase risk of fragility fracture are common complication of anorexia nervosa (AN). BMD by dual-energy X-ray absorptiometry (DXA) present several limits in subjects with AN. This study aimed to evaluate the usefulness of the new Radiofrequency echographic multispectrometry (REMS) technique in the assessment of bone status in young women with AN. METHODS: In a cohort of 50 subjects with restrictive AN and in 30 healthy controls, we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using both DXA and REMS technique. RESULTS: BMD evaluated by DXA and REMS technique at all measurement sites were all significantly (p < 0.01) lower in subjects suffering from AN subjects than in controls. Good correlations were detected between BMD by DXA and BMD by REMS measurements at LS (r = 0.64, p < 0.01) at FN (r = 0.86, p < 0.01) and at TH (r = 0.84, p < 0.01) in subjects suffering from AN. Moreover, Bland-Altman analysis confirmed the good agreement between the two techniques. The subjects suffering from AN with previous vertebral fragility fractures presented lower values of both BMD-LS and BMD-TH by DXA and by REMS with respect to those without fractures; however, the difference was significant only for BMD-TH by REMS (p < 0.05). CONCLUSIONS: Our data suggest that REMS technique due to its characteristic of precision and reproducibility may represent an important tool for the evaluation of the changes in bone status in AN young women, especially during the fertile age and in case of pregnancy and breastfeeding. LEVEL OF EVIDENCE: Level of evidence: level III cohort study.
Authors: Jacob Frølich; Laura A Winkler; Bo Abrahamsen; Niels Bilenberg; Anne P Hermann; René K Støving Journal: Int J Eat Disord Date: 2020-01-10 Impact factor: 4.861
Authors: Elizabeth A Lawson; Daniel A Donoho; Justine I Blum; Erinne M Meenaghan; Madhusmita Misra; David B Herzog; Patrick M Sluss; Karen K Miller; Anne Klibanski Journal: J Clin Psychiatry Date: 2011-08-09 Impact factor: 4.384
Authors: Madhusmita Misra; Karen K Miller; Jennalee Cord; Rajani Prabhakaran; David B Herzog; Mark Goldstein; Debra K Katzman; Anne Klibanski Journal: J Clin Endocrinol Metab Date: 2007-03-13 Impact factor: 5.958
Authors: Elizabeth A Lawson; Daniel Donoho; Karen K Miller; Madhusmita Misra; Erinne Meenaghan; Janet Lydecker; Tamara Wexler; David B Herzog; Anne Klibanski Journal: J Clin Endocrinol Metab Date: 2009-10-16 Impact factor: 5.958
Authors: Monica H Wojcik; Erinne Meenaghan; Elizabeth A Lawson; Madhusmita Misra; Anne Klibanski; Karen K Miller Journal: Bone Date: 2009-11-18 Impact factor: 4.398
Authors: Andrea L Utz; Elizabeth A Lawson; Madhusmita Misra; Diane Mickley; Suzanne Gleysteen; David B Herzog; Anne Klibanski; Karen K Miller Journal: Bone Date: 2008-03-25 Impact factor: 4.398
Authors: Alexander T Faje; Lamya Karim; Alex Taylor; Hang Lee; Karen K Miller; Nara Mendes; Erinne Meenaghan; Mark A Goldstein; Mary L Bouxsein; Madhusmita Misra; Anne Klibanski Journal: J Clin Endocrinol Metab Date: 2013-03-18 Impact factor: 5.958