Impact of low‐weight severity and menstrual status on bone in adolescent girls with anorexia nervosa
Year: 2017
Type: article
Abstract: Clinicians currently use different low-weight cut-offs both to diagnose anorexia nervosa (AN) and to determine AN severity in adolescent girls. The purpose of this study was to evaluate the clinical utility of existing cut-offs and severity criteria by determining which are most strongly associated with risk for low bone mineral density (BMD). Height adjusted BMD Z scores were calculated for 352 females: 262 with AN and 90 healthy controls (controls) (12-20.5 years), using data from the BMD in Childhood Study, for the lumbar spine, whole body less head, and total hip. For most cut-offs used to define low weight (5th or 10th BMI percentile, BMI of 17.5 or 18.5, and 85 or 90% of median BMI), AN had lower BMD Z scores than controls. AN at >85 or >90% expected body weight for height (EBW-Ht) did not differ in BMD Z scores from controls, but differed significantly from AN at ≤85 or ≤90% EBW-Ht. Among AN, any amenorrhea was associated with lower BMD. AN had lower BMD than controls across DSM-5 and The Society for Adolescent Health and Medicine (SAHM) severity categories. The SAHM moderate severity classification was differentiated from the mildly malnourished classification by lower BMD at hip and spine sites. Amenorrhea and %EBW-Ht ≤ 85 or ≤ 90% are markers of severity of bone loss within AN. Among severity categories, BMI Z scores (SAHM) may have the greatest utility in assessing the degree of malnutrition in adolescent girls that corresponds to lower BMD.
DOI: 10.1002/eat.22681
Institutions: Harvard University, Massachusetts General Hospital
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funders: National Institutes of Health, National Heart, Lung, and Blood Institute, National Institute of Mental Health, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1049408530, G1470284823, G1789861183, G2775066458, G3309505724, G3411614775, Harvard Clinical and Translational Science Center (UL1), Growth Hormone and Cardiovascular Disease, G5345734265, G5403062253, Harvard Clinical and Translational Science Center, Hormonal Factors in the Treatment of Anorexia Nervosa, IGF-I and Bone Loss in Women with Anorexia Nervosa, G690901646, G7137532325, Fat Mediated Modulation of Reproductive and Endocrine Function in Young Athletes, Harvard Clinical and Translational Science Center (UL1), G9000085504, G9000145529, G9000259621, G9000330612
OpenAlex ID: W2584719725