Bone mineral density in anorexia nervosa: Only weight and menses recovery?

Abstract Introduction The study objectives were to analyze the presence of reduced bone mass in a sample of patients with anorexia nervosa (AN) and amenorrhea, to assess Bone Mineral Density (BMD) recovery after having a normal weight is reached and regular menses are resumed, and to predict BMD after a treatment period considering different variables (baseline BMD, baseline and final body mass index (BMI), treatment duration). Material & Methods 35 patients with AN (mean age 20.57 ± 5.77) were studied at treatment start (T 0 ) and after they had recovered their normal weight and regular menses (T 1 ) in order to measure their BMD using quantitative computed tomography (QCT) of the lumbar spine (L2–L4). Results At T 0 , 2.86% of patients had normal BMD, while a reduced bone mass consistent with osteopenia or with osteoporosis was found in 22.86% and 74.28% of patients respectively. At T 1 , the percentages were 20%, 20%, and 60% respectively. No significant differences were seen in L2–L3 and mean BMD (L2–L4). A significant difference was however found for L4 ( p 0 –T 1  > 11 months, but not when the time period was ≤11 months. Conclusions This follow-up study of changes not only in BMD but also in BMI and recovery of menses has clinical relevance from the viewpoint of the day-by-day treatment process. Use of QCT makes the study more relevant because this is a more advanced technique that allows for differentiating trabecular and cortical bone.