title: Fractures in patients with anorexia nervosa, bulimia nervosa, and other eating disorders--a nationwide register study.
abstract: OBJECTIVE
  To study fracture risk in patients with anorexia nervosa (AN), bulimia nervosa (BN), or eating disorders not otherwise specified (EDNOS).
  
  
  METHODS
  Cohort study including all Danes diagnosed with AN (n = 2,149), BN (n = 1,294), or EDNOS (n = 942) between 1977 and 1998. Each patient was compared with three randomly drawn age- and gender-matched control subjects.
  
  
  RESULTS
  Fracture risk was increased in AN after diagnosis compared to controls (incidence rate ratio: 1.98, 95% CI: 1.60-2.44), but not before. The increased fracture risk persisted more than 10 years after diagnosis. A significant increase in fracture risk was found before diagnosis in BN (1.31, 95% CI: 1.04-1.64), with a trend towards an increase after diagnosis (1.44, 95% CI: 0.93-2.22). EDNOS patients had a significant increase in fracture risk before (1.39, 95% CI: 1.06-1.81) and after diagnosis (1.77, 95% CI: 1.25-2.51).
  
  
  CONCLUSIONS
  The increased fracture risk many years after diagnosis indicates permanent skeletal damage.
authors.affiliation: Department of Endocrinology and Metabolism C, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark. p-vest@post4.tele.dk
authors.forename: Peter
authors.initials: P
authors.lastname: Vestergaard
authors.forename: Charlotte
authors.initials: C
authors.lastname: Emborg
authors.forename: René K
authors.initials: RK
authors.lastname: Støving
authors.forename: Claus
authors.initials: C
authors.lastname: Hagen
authors.forename: Leif
authors.initials: L
authors.lastname: Mosekilde
authors.forename: Kim
authors.initials: K
authors.lastname: Brixen
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000453:epidemiology*; D002032:Bulimia / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011897:Random Allocation; D012042:Registries