title: [Adolescent with anorexia nervosa: consequences on bone mineralization].
abstract: BACKGROUND
  Anorexia nervosa is responsible for abnormalities in bone mineralization, which are well known and described in adults, but less well documented in adolescents. The aim of this research was to evaluate the frequency and severity and to determine predictive factors for these abnormalities in a population of adolescents with diagnosed anorexia nervosa.
  
  
  METHODS
  This retrospective study involved 39 female adolescents with anorexia nervosa having undergone dual energy X-ray absorptiometry prior to the age of 18 years. Clinical (age, Tanner puberty stages, weight, body mass index [BMI] at different times during the anorexia phase and amenorrhea features), radiological (bone mineral density [BMD] in Z-score units and in absolute values), and biological (calcemia and vitamin D) parameters were collected.
  
  
  RESULTS
  In total, 20 patients (51%) presented osteopenia (Z-score <-1 DS and >-2.5 DS) and 2 (5%) had osteoporosis (Z-score <-2.5 DS). Five (13%) exhibited a Z-score less than -2 DS. BMD expressed in Z-scores correlated with none of the parameters assessed. At univariate analysis, BMD in absolute values correlated with the age at disease onset, BMI, weight loss at the lowest weight achieved and BMI at the time of densitometry (P<0.01). At multivariate analyses, only the correlation with the age at disease onset persisted (P<0.05).
  
  
  CONCLUSIONS
  Bone loss in anorexia nervosa is a complication that may be present as early as adolescence. It must be systematically searched for in all adolescents with severe malnutrition because, even if BMD correlated with nutritional parameters, no clinical predictor for osteoporosis or osteopenia could be identified in this study.
authors.affiliation: Service de pédiatrie, centre Robert-Debré, CHU d'Angers, 4, rue Larrey, 49933 Angers cedex 09, France.
authors.forename: D
authors.initials: D
authors.lastname: Nicaise
authors.forename: M
authors.initials: M
authors.lastname: Beaumesnil
authors.forename: E
authors.initials: E
authors.lastname: Chaillou
authors.forename: A-C
authors.initials: AC
authors.lastname: Wagner
authors.forename: G
authors.initials: G
authors.lastname: Avarello
authors.forename: M
authors.initials: M
authors.lastname: Audran
authors.forename: J-L
authors.initials: JL
authors.lastname: Giniès
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000465:Algorithms; D000568:Amenorrhea / Q000209:etiology; D000704:Analysis of Variance; D000856:Anorexia Nervosa / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D001835:Body Weight; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D002118:Calcium / Q000097:blood; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000097:blood
chemical_list: D015415:Biomarkers; D014807:Vitamin D; D002118:Calcium