Osteopenia and osteoporosis in adult patients with anorexia nervosa. Role of nutritional factors

Lorenza Caregaro, L. Di Pascoli, M. Nardi, P. Santonastaso, G. Boffo, V. Camozzi, G. Luisetto, A. Favaro

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Abstract

Objective: To assess the prevalence and predictive factors of bone mineral loss in adult patients with anorexia nervosa (AN). Methods: Bone mineral density (BMD) was assessed by DEXA at femoral and lumbar sites in 90 adult patients with AN, consecutively admitted to the Unit for Eating Disorders of Padua University. A series of univariate regressions and then stepwise multiple regression models were used to evaluate the effects on BMD of body mass index (BMI), BMI before illness, fat mass, fat-free mass, muscle mass, muscle strength, calcium and energy intake, insulin-like growth factor 1 (IGF- 1), physical activity, smoking, duration of illness, age at onset of AN, age of menarche, presence of sporadic menses and AN subtype. Results: Eighty percent of patients showed a reduced BMD at any site: 51.1% had osteopenia and 28.9% osteoporosis. In the subgroup of 31 patients with short duration of illness (≤24 months) 61.3% had osteopenia and 6.5% osteoporosis. Univariate assessment in the whole group of patients showed a strong association of BMD at any site with BMI, fat mass, fat-free mass, muscle mass, IGF-1 and duration of illness. Femoral BMD was also associated with smoking, and lumbar BMD with muscle strength. In the stepwise multiple regression analysis, duration of illness and BMI were identified as independent predictors of femoral BMD, accounting for 44% of variance. The independent predictors of lumbar BMD were duration of illness and fat mass, accounting for 28% of variance. Conclusions: Bone mineral loss represents a common complication of AN, including in adult patients with short duration of illness (≤24 months). Nutritional parameters and duration of illness independently predict bone mineral loss.

Original languageEnglish
Pages (from-to)194-202
Number of pages9
JournalNutritional Therapy and Metabolism
Volume24
Issue number4
DOIs
Publication statusPublished - Oct 2006

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Keywords

  • Anorexia nervosa
  • BMI
  • Bone mineral density
  • Fat mass
  • Fat-free mass
  • Malnutrition
  • Muscle mass
  • Osteopenia
  • Osteoporosis
  • Physical activity
  • Smoking

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics

Cite this

Caregaro, L., Di Pascoli, L., Nardi, M., Santonastaso, P., Boffo, G., Camozzi, V., Luisetto, G., & Favaro, A. (2006). Osteopenia and osteoporosis in adult patients with anorexia nervosa. Role of nutritional factors. Nutritional Therapy and Metabolism, 24(4), 194-202. https://doi.org/10.5301/NTM.2012.9443