Longitudinal changes in bone parameters in young girls with anorexia nervosa

Area of Science:

• Pediatric Endocrinology
• Bone Metabolism
• Adolescent Health

Background:

• Childhood and adolescent anorexia nervosa (AN) can negatively impact bone health.
• Longitudinal studies on bone health in adolescents with AN are limited.

Purpose of the Study:

• To assess longitudinal changes in bone parameters and body composition in young girls with AN.
• To examine correlations with growth, body composition changes, and effects of illness duration and menstruation.

Main Methods:

• Retrospective assessment of DXA-derived bone parameters and body composition in 111 adolescent girls with AN.
• Vertebral fracture assessment (VFA) performed in 68 patients; follow-up DXA in 31.
• Calculation of size-adjusted DXA standard deviation scores for total body less head bone mineral content (TBLH-BMC) and lumbar spine bone mineral apparent density (LS-BMAD).

Main Results:

• Baseline mean bone area and lean mass were below average for height.
• Lumbar spine bone mineral apparent density (LS-BMAD) SDS decreased slightly over time.
• Significant increases in lean mass and fat mass were observed.
• Illness duration negatively predicted LS-BMAD; height recovery positively predicted improvements in TBLH-BMC and LS-BMAD.
• Mild vertebral fractures were identified in 5.9% of patients.

Conclusions:

• Adolescents with AN exhibit smaller and less dense bones compared to healthy peers.
• Despite improvements in lean and fat mass, BMAD SDS shows a slight decline over time.
• Recovery of BMAD SDS is associated with improved height SDS.