Osteoporosis International

, Volume 18, Issue 6, pp 797–804

Bone cross-sectional geometry in adolescents and young women with anorexia nervosa: a hip structural analysis study

  • A. D. DiVasta
  • T. J. Beck
  • M. A. Petit
  • H. A. Feldman
  • M. S. LeBoff
  • C. M. Gordon
Original Article

DOI: 10.1007/s00198-006-0308-6

Cite this article as:
DiVasta, A.D., Beck, T.J., Petit, M.A. et al. Osteoporos Int (2007) 18: 797. doi:10.1007/s00198-006-0308-6



Better characterization of bone geometry in adolescents with anorexia nervosa (AN) may improve understanding of skeletal deficits in this population. Our objective was to determine whether hip cross-sectional geometry and bone strength were altered in adolescents with AN.


Measurements of the left total proximal femur and body composition were obtained in 85 adolescents with AN and 61 healthy controls by dual X-ray absorptiometry. The Hip Structural Analysis (HSA) program was used to determine aBMD, cross-sectional area (CSA), and section modulus (Z) at the femoral neck and shaft. Strength indices were calculated and corrected for lean mass.


Femoral neck and shaft aBMD were lower in AN patients than healthy controls (−36% and −29%, p < 0.001). In both regions, bone CSA and Z were lower in AN sufferers (−11 to −35%, p < 0.001). While lean body mass correlated with HSA variables (r = 0.48 to 0.58, p < 0.001), body fat did not. AN sufferers had lower indices of both whole bone strength (−40%, p < 0.001) and relative bone strength (−36%, p < 0.001) than controls.


Anorexia nervosa sufferers had decreased resistance to axial (CSA) and bending loads (Z) compared with healthy controls. Differences in strength properties were significant even when adjusted for lean mass, suggesting that not only decreased mechanical loading, but also known metabolic differences are likely responsible for deficits in bone strength in these patients.


Adolescents Anorexia nervosa Bone geometry Bone strength Malnutrition 

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • A. D. DiVasta
    • 1
  • T. J. Beck
    • 2
  • M. A. Petit
    • 3
  • H. A. Feldman
    • 4
  • M. S. LeBoff
    • 5
  • C. M. Gordon
    • 1
    • 6
  1. 1.Division of Adolescent MedicineChildren’s Hospital BostonBostonUSA
  2. 2.Department of RadiologyJohns Hopkins UniversityBaltimoreUSA
  3. 3.School of KinesiologyUniversity of MinnesotaMinneapolisUSA
  4. 4.Clinical Research ProgramChildren’s Hospital BostonBostonUSA
  5. 5.Skeletal Health and Osteoporosis ProgramBrigham and Women’s HospitalBostonUSA
  6. 6.Division of EndocrinologyChildren’s Hospital BostonBostonUSA

Personalised recommendations