AB0286 LONG-TERM EFFECTS OF WEIGHT RESTORATION ON BONE MINERAL DENSITY (BMD) IN PATIENTS WITH ANOREXIA NERVOSA

• Published in: Annals of the rheumatic diseases Vol. 83; no. Suppl 1; pp. 1386 - 1387
• Main Authors: Adami, G., Fassio, A., Simona, C., Molgora, M., Chimini, M., Segattini, B., Gatti, D., Rossini, M., Dalle Grave, A., Dalle Grave, R.
• Format: Journal Article
• Language: English
• Published: Kidlington BMJ Publishing Group Ltd and European League Against Rheumatism 01.06.2024; Elsevier B.V; Elsevier Limited
• Subjects: Anorexia; Body composition; Body mass index; Bone; Bone density; Bone loss; Bone mass; Bone mineral density; Diet and Nutrition; Eating disorders; Femur; Fractures; Long-term effects; Observational studies/ registry; Scientific Abstracts; Spine (lumbar); Standard scores; Vitamin D; Weight; Diet and Nutrition; Bone; Observational studies/ registry
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/annrheumdis-2024-eular.2655

Background:Anorexia nervosa is an eating disorder characterized by extremely low body mass index (BMI) with consequent low bone mineral density (BMD) and higher risk of fractures.Objectives:To investigate the long-term effects of body weight restoration on BMD in patients with anorexia nervosa.Methods:We conducted a prospective observational study of patients with anorexia nervosa admitted to an eating disorder clinic for intensive weight restoration program, inpatient (20-week program) followed by an outpatient long-term follow-up. Clinical, demographic, body composition and BMD data were collected at baseline (admission), at week 20 (W20) and after >5 years.Results:53 women were enrolled in the study. Mean age at baseline was 32±9.2 years and the median follow-up was 8.0 years (IQR 9.1-7.0). Mean BMI at baseline was 15.8±1.7. Lumbar spine BMD Z-score at baseline was -0.72±1.14, femoral neck Z-score at baseline was -0.37±0.97 and total hip Z-score at baseline was -0.40±1.06. All patients had normal (>20 ng/mL) 25-OH-vitamin D levels throughout the study. All subjects achieved BMI ≥18 at W20 and in aggregate BMD increased at all sites at W20. However, after a median follow-up of 8.1 years (IQR 7.3-8.6), 14 patients had BMI <18 (weight loss after discharge – in red in the figures), whereas 39 subjects kept BMI ≥18 over a median follow-up of 8.0 years (IQR 6.9-9.2), in blue in the figures. Figure 1 shows the cumulative probability of losing BMD at various sites stratified by maintenance of BMI above or below the threshold of 18. Figure 2 shows the trend in BMD levels at the femur and lumbar spine in patients that maintained BMI≥18 or <18.Figure 1.Figure 2.Conclusion:In aggregate, short-term weight restoration was associated with a significant increase in BMD at all sites. Keeping BMI ≥18 in the long term was associated with a positive non-plateau effect on lumbar spine BMD. In contrast, weight loss after discharge was associated with a significant bone loss at all sites.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:Giovanni Adami Theramex, UCB, Lilly, Galapagos, Fresenius Kabi, Amgen, BMS, Abiogen and Pfizer, Angelo Fassio: None declared, Calugi Simona: None declared, Manuela Molgora: None declared, Mirko Chimini: None declared, Barbara Segattini: None declared, Davide Gatti: None declared, Maurizio Rossini: None declared, Anna Dalle Grave: None declared, Riccardo Dalle Grave: None declared.