Bone mineral density at extremely low weight in patients with anorexia nervosa

Bemer P, Di Lodovico L, Haykanush O, Théodon H, Briot K, Carlier R, Dicembre M, Duquesnoy M et al.

Clinical endocrinology, 2021

Abstract

OBJECTIVE: Low bone mineral density (BMD) is a frequent and invalidating consequence of chronic undernourishment in patients with anorexia nervosa (AN). The aim of this study was to assess prevalence and clinic-biological correlates of low BMD and fractures in extremely undernourished inpatients with AN.

DESIGN: Retrospective cohort study.

PATIENTS AND MEASUREMENTS: This study included 97 extremely malnourished female inpatients with AN consecutively admitted over 2 years. Clinical-biological variables, history of fractures and BMD by dual-energy X-ray absorptiometry (DXA) were examined to find predictors of low BMD and fractures.

RESULTS: The prevalence of low BMD was of 51% for lumbar spine and 38% for femoral neck. Z-scores were lower at lumbar spine (-2.2 ± 1.2 SD) than at femoral neck (-1.9 ± 0.9 SD) (P<.01). Fragility fractures were reported by 10% of patients. BMD was mainly predicted by FFM, illness duration, age at onset and restricting AN (P<.05). Fractures were predicted by sodium concentrations, femoral neck Z-score and illness duration (P<.03).

CONCLUSION: Extremely severe patients with AN have high prevalence of low BMD, predicted by severity and chronicity of malnutrition.

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

Read the paper

• DOI
• PubMed
• Publisher page

Related studies

• Development of a crushable foam model for human trabecular bone Medical engineering & physics, 2021
• Data-driven motion compensation in HR-pQCT. Biomedical physics & engineering express, 2026
• Modeling of structure, quality, and function in the orthodontic patient Orthodontics & craniofacial research, 2003
• Exploring the mechanism of Heidihuang Pill in the treatment of osteoporosis based on network pharmacology, molecular docking, and experimental validation Frontiers in endocrinology, 2025
• Effect of fabric on the accuracy of computed tomography-based finite element analyses of the vertebra Biomechanics and modeling in mechanobiology, 2020
• Use of interventions involving virtual reality tasks during the climacteric: a systematic review Climacteric : the journal of the International Menopause Society, 2022

Go deeper in Evidence Hub

Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.

Open this study Sign up free