[Bone density in anorexia nervosa--with comments on prevention and therapy of osteoporosis]

Anorectic women often have reduced bone density, which may predispose them to osteoporosis and fractures. The mechanisms involved and their relative contribution are still a matter of discussion. Most studies have been done in young adults, but during the past few years children and adolescents have also been investigated. In this paper we present preliminary data on bone mineral parameters in young anorectic females during the first few months of inpatient treatment. Measurement of trabecular bone density (TBD), bone mineral density (BMD) and body composition were done by peripheral quantitative computed tomography (pQCT) at the distal end of the radius and by dual-energy X-ray absorptiometry (DEXA) in ap-projection. Hormonal parameters and clinical course were monitored. Baseline values of TBD and BMD seemed to be generally within the normal range. Follow-up measurements showed a significant reduction in TBD but not in BMD in most patients during the first two months of treatment despite clinical improvement. There was no clear correlation with hormonal or clinical parameters. Further evaluations are necessary. Possible therapeutic consequences are discussed.