title: Bone mineral density in anorexia nervosa: Only weight and menses recovery?
abstract: BACKGROUND
  The study objectives were to analyze the presence of reduced bone mass in a sample of patients with anorexia nervosa (AN) and amenorrhea, to assess Bone Mineral Density (BMD) recovery after having a normal weight is reached and regular menses are resumed, and to predict BMD after a treatment period considering different variables (baseline BMD, baseline and final body mass index (BMI), treatment duration).
  
  
  METHODS
  35 patients with AN (mean age 20.57±5.77) were studied at treatment start (T0) and after they had recovered their normal weight and regular menses (T1) in order to measure their BMD using quantitative computed tomography (QCT) of the lumbar spine (L2-L4).
  
  
  RESULTS
  At T0, 2.86% of patients had normal BMD, while a reduced bone mass consistent with osteopenia or with osteoporosis was found in 22.86% and 74.28% of patients respectively. At T1, the percentages were 20%, 20%, and 60% respectively. No significant differences were seen in L2-L3 and mean BMD (L2-L4). A significant difference was however found for L4 (p<0.05). A positive relationship was seen between final body mass index (BMI) and final BMD in patients with T0-T1>11 months, but not when the time period was ≤11 months.
  
  
  CONCLUSIONS
  This follow-up study of changes not only in BMD but also in BMI and recovery of menses has clinical relevance from the viewpoint of the day-by-day treatment process. Use of QCT makes the study more relevant because this is a more advanced technique that allows for differentiating trabecular and cortical bone.
authors: Area of Nutrition and Food Sciences, Department of Molecular Biology and Biochemical Engineering, Universidad Pablo de Olavide, Seville, Spain; Behavioural Sciences Institute, Seville, Spain. Electronic address: ignacio-ja@telefonica.net.
authors: Ignacio
authors: I
authors: Jáuregui-Lobera
authors: Behavioural Sciences Institute, Seville, Spain.
authors: Patricia
authors: P
authors: Bolaños-Ríos
authors: Centro Ecotest, Seville, Spain; Universidad de Sevilla, Seville, Spain.
authors: Juan
authors: J
authors: Sabaté
mesh_terms: D000293:Adolescent; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications* / Q000628:therapy; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology; D003289:Convalescence; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008598:Menstruation; D010024:Osteoporosis / Q000209:etiology; D015430:Weight Gain; D055815:Young Adult
keywords: Amenorrea; Amenorrhea; Anorexia nerviosa; Anorexia nervosa; Bone mineral density; Densidad mineral ósea; Osteopenia; Osteoporosis; Quantitative computed tomography; Tomografía computarizada cuantitativa