title: Prevalence and clinical determinants of low bone mineral density in anorexia nervosa.
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 <or= -1.0 in at least one site (lumbar spine or femoral neck).
  
  
  RESULTS
  A Z-score of <or= -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).
  
  
  CONCLUSIONS
  We conclude that low BMD is frequent in AN. The best indicator of low BMD appeared to be the lowest reported BMI ever.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, University Hospital Maastricht, The Netherlands.
authors.forename: Marielle
authors.initials: M
authors.lastname: Hofman
authors.forename: Sabine
authors.initials: S
authors.lastname: Landewé-Cleuren
authors.forename: Franz
authors.initials: F
authors.lastname: Wojciechowski
authors.forename: Arie Nieuwenhuijzen
authors.initials: AN
authors.lastname: Kruseman
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000856:Anorexia Nervosa / Q000453:epidemiology*; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D016015:Logistic Models; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008572:Menarche; D008875:Middle Aged; D015995:Prevalence; D055815:Young Adult