Lopes Mariana P, Ahmed Sana, Beaman Lily, Stubbs Brendon, Campbell Iain C, Schmidt Ulrike, Robinson Lauren
Department of Psychological Medicine, Centre for Research in Eating and Weight Disorders, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Nutrition Department, School of Public Health University of São Paulo, São Paulo, Brazil.
Eur Eat Disord Rev. 2025 May;33(3):447-459. doi: 10.1002/erv.3153. Epub 2024 Nov 21.
To investigate fractures history in women with first episode anorexia nervosa (AN) (FE-AN: ≤ 3 years duration) and those with persistent AN (P-AN: ≥ 7 years), compared to healthy controls (HC).
One hundred nineteen women (FE-AN = 49, P-AN = 46 and HC = 24) completed online questionnaires on eating disorders symptoms, their menstrual and their fracture history.
Average illness duration was 1.9 years (SD = 0.8) in FE-AN and 15.3 years (SD = 8.5) in P-AN. Lifetime history of all fractures, including stress fractures, was higher in AN groups (FE-AN = 33.3%; P-AN = 37.8%) than in HC (4.2%, p < 0.001). P-AN participants were 13.4 times more likely to report a fracture compared to HC, irrespective of age, whereas F-AN participants were 10.3 times more likely. In P-AN, higher BMI, shorter duration of amenorrhoea and history of pregnancy were inversely associated with fracture number.
There is an increased risk of bone fracture even in the early stages of AN. This could be related to a time lapse between the initial symptoms of AN and formal diagnosis. This suggests guidelines recommending bone screening after 2-years of persistent low weight for adults should be revisited, and the risk of bone problems should be part of the dialogue between clinicians, patients and carers at the earliest opportunity.
调查首次发作神经性厌食症（AN）（FE-AN：病程≤3年）和持续性AN（P-AN：病程≥7年）的女性的骨折史，并与健康对照者（HC）进行比较。
119名女性（FE-AN = 49名，P-AN = 46名，HC = 24名）完成了关于饮食失调症状、月经和骨折史的在线问卷。
FE-AN组的平均病程为1.9年（标准差 = 0.8），P-AN组为15.3年（标准差 = 8.5）。AN组（FE-AN = 33.3%；P-AN = 37.8%）所有骨折（包括应力性骨折）的终生史高于HC组（4.2%，p < 0.001）。无论年龄如何，P-AN参与者报告骨折的可能性是HC参与者的13.4倍，而F-AN参与者是10.3倍。在P-AN组中，较高的体重指数、较短的闭经持续时间和怀孕史与骨折数量呈负相关。
即使在AN的早期阶段，骨折风险也会增加。这可能与AN的初始症状和正式诊断之间的时间间隔有关。这表明，建议对成年人持续低体重2年后进行骨筛查的指南应重新审视，并且骨问题的风险应尽早成为临床医生、患者和护理人员之间对话的一部分。
