Screening for osteoporosis in anorexia nervosa: prevalence and predictors of reduced bone mineral density.
OBJECTIVE
Decreased bone mineral density (BMD) in anorexia nervosa (AN) can be detected easily by dual-energy X-ray absorptiometry (DXA). This study was designed to assess the prevalence of osteoporosis and osteopenia in AN, identify predictors, and determine the diagnostic yield of screening with DXA.


METHODS
DXA was used to screen 59 unselected adult patients with a history of AN.


RESULTS
Osteoporosis was identified in 18 patients (31%) and osteopenia in 30 (51%). The spine had a lower mean T-score than either the hip or femur. BMI significantly predicted T-score (p = 0.0006) and the odds of having osteoporosis (p = 0.0188). There was a significant association between use of oestrogens and the presence of osteoporosis or osteopenia (p = 0.0491). There was no significant association between duration of AN and T-score. A duration of AN of less than 1 year was found in 12% of those with osteoporosis.


CONCLUSIONS
BMI is a strong predictor of BMD in AN. DXA is an effective screening tool and should probably be offered routinely.
Winston
Anthony P
AP
Eating Disorders Unit, Woodleigh Beeches Centre, Warwick Hospital, Warwick, United Kingdom. Anthony.Winston@covwarkpt.nhs.uk
Alwazeer
Ahmed E F
AE
Bankart
Michael J G
MJ
D015502:Absorptiometry, Photon; D000328:Adult; D000856:Anorexia Nervosa / Q000175:diagnosis* / Q000453:epidemiology*; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D010024:Osteoporosis / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012720:Severity of Illness Index