[Study of bone repercussion in 33 cases with anorexia nervosa which 8 with fracture osteoporosis].
A national survey has regrouped 33 cases of anorexia nervosa (AN) with osseous investigations, in particular an absorptiometry of the lumbar spine. 2 groups have been defined: 25 patients without fracture (F-) and 8 patients with osteoporotic fractures (F+), including 5 cases with 12 vertebral fractures and 5 with non vertebral fractures: 31/33 have a low lumbar bone mineral content (BMC). The lumbar BMC of the F+ is significantly lower than the F-: -4.1 +/- 1.6 DS versus -2.2 +/- 1.2 DS (p less than 0.001). 5 F+ patients are under the fracture threshold (FT), (O F-), 2 F+ are on the same level as the FT, and the last F+ has a lumbar BMC 15% above the FT, but an osteoporotic wrist fracture and a very low femoral neck BMC (0.64 g/m2, normal 1.06 +/- 0.15). F+ are older (35.2 year old versus 23.6, p less than 0.001), owing the fact that the duration of the AN (+ 9.2 years, p less than 0.005) and of the amenorrhea (+ 9.8 years, p less than 0.001) are longer, although the AN began at the same age in the 2 groups. The minimum weight, the body mass index, the percentage of loss of weight are similar in the 2 groups. Phosphocalcic biological studies, which show rather high osteocalcinemia and hydroxyprolinuria (hyperremodeling), with rather high serum 1-25 OH vitamin D, do not differ between the 2 groups. Endocrinologic evaluations, with a constant hypooestradiolemia of hypothalamic origin, low somatomedinemia and normal cortisolemia, are not different between the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Maugars
Y
Y
Service de Rhumatologie, CHR Nantes.
Clochon
P
P
Grardel
B
B
Hary
S
S
Phélip
X
X
Forestier
R
R
Gest
D
D
Vilon
P
P
Venisse
J L
JL
Audran
M
M
D015502:Absorptiometry, Photon; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000378:metabolism; D015519:Bone Density; D002118:Calcium / Q000032:analysis; D005260:Female; D005598:Fractures, Spontaneous / Q000209:etiology*; D006801:Humans; D008159:Lumbar Vertebrae / Q000378:metabolism; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology*
D002118:Calcium
Etude du retentissement osseux dans 33 cas d'anorexie mentale dont 8 avec une osteoporose fracturaire.