title: Follow-up of bone mineral density and body composition in adolescents with restrictive anorexia nervosa: role of dual-energy X-ray absorptiometry.
abstract: OBJECTIVE
  Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass-FM and lean mass-LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal status and sport in female adolescents with restrictive anorexia nervosa-ANR.
  
  
  METHODS
  Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry-DXA at baseline-T0 and after 12 months-T12. Among the 46/79-58.2% patients that completed the study, we evaluated total and regional FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/hormonal therapy and physical activity.
  
  
  RESULTS
  At T0: body mass index (BMI)=16.4±1.4 kg/m2 with low levels of FM% (21.7±5.7) low BMC in 12/46-26.0% (mean Z-score: -1.21±1.27, with higher values related to physical activity-P=0.001). At T12: a significant increase in BMI-P=0.001, with LM reduction and FM increase (more evident in the trunk-P<0.001); regarding bone, no significant changes were observed, though a tendency in terms of improvement associated with resumption of menses.
  
  
  CONCLUSIONS
  After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost technique, in long-term monitoring of ANR patients.
authors.affiliation: Child Neuropsychiatric Unit, Women, Children and Adolescents Health Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Franzoni
authors.affiliation: Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ciccarese
authors.affiliation: Child Neuropsychiatric Unit, Women, Children and Adolescents Health Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Di Pietro
authors.affiliation: Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Facchini
authors.affiliation: Child Neuropsychiatric Unit, Women, Children and Adolescents Health Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Moscano
authors.affiliation: Child Neuropsychiatric Unit, Women, Children and Adolescents Health Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Iero
authors.affiliation: Child Neuropsychiatric Unit, Women, Children and Adolescents Health Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Monaldi
authors.affiliation: Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S.Orsola-Malpighi, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Battista
authors.affiliation: 1] Radiology Unit, Cardio-Thoracic-Vascular Department, University Hospital S.Orsola-Malpighi, Bologna, Italy [2] Diagnostic and Interventional Radiology, Special Orthopedic-Trauma Pathology Department, The Rizzoli Institute, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bazzocchi
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000568:Amenorrhea / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications / Q000503:physiopathology*; D001823:Body Composition; D015992:Body Mass Index; D018488:Bone Demineralization, Pathologic / Q000209:etiology; D015519:Bone Density; D015444:Exercise; D005260:Female; D006801:Humans; D011446:Prospective Studies; D055815:Young Adult