TITLE:
Is osteoporosis risk in anorexia nervosa underestimated? A case report series
AUTHORS:
Bruno Pacciardi, Claudio Cargioli, Simone Belli, Biagio Cotugno, Samanta Augusto, Luca Di Paolo, Mauro Mauri
KEYWORDS:
Anorexia Nervosa; Amenorrhea; Osteoporosis; Fracturerisk; DXA; BMD
JOURNAL NAME:
Open Journal of Internal Medicine,
Vol.3 No.4,
December
11,
2013
ABSTRACT: Introduction: Anorexia
nervosa (AN) is a mental disorder whose features are deliberate weight loss,
disordered body image, and intrusive overvalued fears of gaining weight. Long-term
consequences of AN include endocrine dysfunctions leading to secondary amenorrhea, bone loss and/or osteoporosis with an increased risk of
bone fracture. Therefore young women with AN may develop a risk for bone
fractures comparable to that of postmenopausal women. Methods: In this case
report series Bone Mineral Density (BMD) was examined by Dual energy X-ray
Absorptiometry (DXA) in 19 hospitalized patients with diagnosis of AN and
prolonged amenorrhea. Results: All patients showed a lumbar/femoral bone loss
or osteoporosis, with an increased fracture risk comparable to that of
postmenopausal women. Conclusions: Our observation
suggests that DXA evaluation of anorexic patients with prolonged amenorrhea
would be helpful to prevent fracture risk in this population of patients.
However, although DXA is almost routinely recommended in women over 65, it is
not in young AN patients with prolonged amenorrhea.