Adequate nutrition status important for bone mineral density improvement in a patient with anorexia nervosa

Yukio Nakamura,1,2 Mikio Kamimura,3 Hidefumi Koiwai,4 Hiroyuki Kato1 1Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan; 2Department of Orthopedic Surgery, Showa-Inan General Hospital, Komagane, Japan; 3Center of Osteoporosis and Spinal Disorders, Kamimura Orthopedic Clinic, Matsumoto, Japan; 4Koiwai Orthopedic Clinic, Komoro, Japan Abstract: Low bone mineral density (BMD) is one of the most frequent complications of anorexia nervosa (AN). We report the clinical outcomes of a female patient with severe AN, whose chest had become deformed due to thoracic fracture. Lumbar BMD was 0.358 g/cm2 (T-score = −6.3), and total hip BMD was 0.411 g/cm2 (T-score = −4.4). Active vitamin D increased these parameters by 81.0% and 57.4%, respectively, but a drop in her nutrition status afterward resulted in a sharp decrease in BMD values. These findings suggest that adequate nutrient intake is essential for effective osteoporosis treatment in patients with AN. Keywords: anorexia nervosa, bone mineral density, daily teriparatide, osteoporosis