Bone mineral density and body mass composition measurements in premenopausal anorexic patients: The impact of lean body mass
Abstract
Introduction Evaluating bone density and body composition by dual-energy x-ray absorptiometry (DXA) and analyzing their relationships among young anorexic women in comparison with normal-lean matched controls.Materials and methods In this observational cohort study, 98 normal-underweight young females were enrolled (aged more than 16 and less than 24 years). The study group included 68 anorexic patients and 30 healthy age-matched controls. The patients underwent a DXA examination to evaluate bone mineral density and body composition. Several indexes of body composition were used: the FMI (Fat Mass Index), the TLMI (Total Lean Mass Index) and the SMI (Skeletal Muscle mass Index) the last one as a marker of sarcopenia.Results According to the ISCD (International Society for Clinical Densitometry) criteria, a significantly higher percentage of anorexic patients were found to be below the expected range for age as compared to controls (P < 0.01). According to WHO criteria, 20% of the anorexic patients presented an osteoporotic T-score index at the lumbar level and 18% presented an osteoporotic T-score at the femoral level. As regards the lean body characteristics, the SMI and TLMI were significantly lower in the anorexic population (P < 0.01 and P < 0.001, respectively) and 24% of the anorexic patients presented SMI values that are indicative of pre-sarcopenia. In addition, only the SMI significantly correlated with both the lumbar and the femoral BMD values.Conclusion Anorexic patients have a very high risk of osteoporosis and fractures. Bone density is influenced by fat body mass and also significantly by lean body mass. Special consideration should be given to the sarcopenic condition since it is a worsening factor of bone health.
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Additional studies using insulin or glucagon stimulation tests confirmed normalization of the adrenal axis in the majority of children over time.
“Additional studies using insulin or glucagon stimulation tests confirmed normalization of the adrenal axis in the majority of children over time [43,48,49].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [43]
Such damage leads to impaired secretion of luteinizing hormone and follicle-stimulating hormone, ultimately causing delayed onset or interruption in the progression of secondary sexual characteristics.
“Such damage leads to impaired secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), ultimately causing delayed onset or interruption in the progression of secondary sexual characteristics [41,42,43].”
From Endocrine Dysfunctions After Pediatric Traumatic Brain Injury: Present Insights and Future Directions (2025) · cites this paper as [43]
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- Authors
- Villa, P., Cipolla, C., Amar, I., Sodero, G., Pane, L. C., Ingravalle, F., Pontecorvi, A., & Scambia, G.
- Affiliations
- Università Cattolica del Sacro Cuore (IT)
- Corresponding author
- Sodero, Giorgio
- Venue
- Journal of Bone and Mineral Metabolism
- Published
- 2024-01
- Volume
- 42
- Issue
- 1
- Pages
- 134-141
- ISSN
- 0914-8779 (ISSN-L)
- 1435-5604
- OpenAlex
- W4390755581
- Cited by
- 13
- References
- 36
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 3
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Bone and Mineral Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- anorexia nervosa, bone mineral density, body composition, lean body mass, sarcopenia, osteoporosis, premenopausal women, fat mass index, skeletal muscle index, fracture risk
- MeSH terms
- Body Composition, Female, Humans, Osteoporosis, Absorptiometry, Photon, Bone Density, Sarcopenia
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