[Osteopenia: a consequence of anorexia nervosa]

The bone density in the spine and femoral neck was measured by dual-energy X-ray absorptiometry in 24 female with anorexia nervosa 14 to 34 y.o. (20.6 +/- 5.5 y.o.). Osteopenia or osteoporosis were always present. All the cases presented with hypogonadotrophic hypogonadism and secondary amenorrhea between 4 and 194 months (40.6 +/- 53.8 months) and with low levels of oestradiol and gonadotrophins. The anorectic patient cumulates hypogonadism and a low intake of calories, calcium and vitamin D, which causes a low body mass index. These factors are more important when present before peak bone mass is reached. The gonadotrophic deficit in the young anorectic male is less obvious clinically than in the young female with amenorrhea but can be however documented with hormonal data. The osteopenia of the anorectic girl can be at least partially corrected with the hormonal and nutritional treatment. In order to reach an adequate peak bone mass in late adolescence or early adulthood and to prevent the development of osteopenia, the male and female anorectic patients should receive a hormonal substitution and an adequate nutritional supply of calcium and vitamin D, as soon as the diagnosis has been made.