Prevalence and predictive factors for regional osteopenia in women with anorexia nervosa

Background: Anorexia nervosa is highly prevalent among young women. Objective: To determine prevalence and predictive factors for regional bone loss. Design: Prospective cohort analysis. Setting: University hospital. Patients: 130 women with anorexia nervosa. Measurements: Dual-energy x-ray absorptiometry. Results: The prevalence of osteopenia (-1.0 SD greater than or equal to T-s core > -2.5 SD) and osteoporosis (T-score less than or equal to -2.5 SD) wa s 50% and 13% for the anterior-posterior spine, 57% and 24% for the lateral spine, and 47% and 16% for the total hip, respectively. Bone mineral densi ty (BMD) was reduced by at least 1.0 SD at one or more skeletal sites in 92 % of patients and by at least 2.5 SD in 38% of patients. Weight was the mos t consistent predictor of BMD at all skeletal sites. Twenty-three percent o f patients were current estrogen users, and 58% were previous estrogen user s. Bone mineral density did not differ by history of estrogen use at any si te. Conclusions: Bone mineral density is reduced at several skeletal sites in m ost women with anorexia nervosa. Weight, but not estrogen use, is a signifi cant predictor of BMD in this population at all skeletal sites.