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BACKGROUND Anorexia nervosa is highly prevalent among young women. OBJECTIVE To determine prevalence and predictive factors for regional bone loss. METHODS Prospective cohort analysis. METHODS University hospital. METHODS 130 women with anorexia nervosa. METHODS Dual-energy x-ray absorptiometry. RESULTS The prevalence of osteopenia (-1.0 SD >/= T-score > -2.5 SD) and osteoporosis (T-score </= -2.5 SD) was 50% and 13% for the anterior-posterior spine, 57% and 24% for the lateral spine, and 47% and 16% for the total hip, respectively. Bone mineral density (BMD) was reduced by at least 1.0 SD at one or more skeletal sites in 92% of patients and by at least 2.5 SD in 38% of patients. Weight was the most consistent predictor of BMD at all skeletal sites. Twenty-three percent of patients were current estrogen users, and 58% were previous estrogen users. Bone mineral density did not differ by history of estrogen use at any site. CONCLUSIONS Bone mineral density is reduced at several skeletal sites in most women with anorexia nervosa. Weight, but not estrogen use, is a significant predictor of BMD in this population at all skeletal sites.
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