Abstract
Objective To determine the prevalence of low bone mass in anorexia nervosa (AN) and the association with clinical parameters. Methods A cross-sectional study on 286 Caucasian women with AN. Bone mineral density (BMD) was measured with DXA. Low BMD was defined as a Z-score ≤ − 1.0 in at least one site (lumbar spine or femoral neck). Results A Z-score of ≤ − 1.0 in at least one of these sites was found in 46.9%. In comparison with the patients with normal BMD, in patients with a low BMD both the BMI at the time of DXA ( p = 0.005) and the lowest BMI ever ( p < 0.001) was lower. These patients also had a longer duration of AN ( p = 0.047). The decline of BMI per year between highest BMI ever and BMI at time of DXA was more rapid in subjects with a normal BMD ( p = 0.016) as compared to patients with low BMD. Low BMD was found to be independently associated with ‘lowest BMI ever’ (OR: 0.78; 95%CI = 0.66–0.93), and with ‘BMI decline per year’ (OR: 0.83; 95%CI = 0.71–0.97). Conclusion We conclude that low BMD is frequent in AN. The best indicator of low BMD appeared to be the lowest reported BMI ever.
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