European Spine Journal

, Volume 27, Issue 2, pp 293–297 | Cite as

Prevalence of idiopathic scoliosis in anorexia nervosa patients: results from a cross-sectional study

  • Fabio Zaina
  • Francesca Pesenti
  • Luca Persani
  • Paolo Capodaglio
  • Stefano Negrini
  • Nicoletta Polli
Original Article

Abstract

Purpose

A long debate exists about the connection between anorexia nervosa (AN) and scoliosis due to conflicting evidence. No study so far has evaluated the prevalence of scoliosis in patients with AN. The aim of the study is to evaluate the prevalence of idiopathic scoliosis in patients with AN.

Methods

Design: cross-sectional study. Study group: convenience sample of all patients matching the inclusion criteria. Control group: female participants coming from an epidemiological screening for scoliosis. Inclusion criteria: patients had a diagnosis of AN during adolescence according to the DSM-IV-TR criteria. We applied a two-level screening using a Bunnell scoliometer and a radiograph. We calculated the odds ratio compared with participants coming from a school screening.

Results

Seventy-seven females with AN were compared to 816 females screened for scoliosis. The prevalence of scoliosis in the AN group was 16.9% (OR 5.77, 95% CI 3.12–10.67) with respect to the control group. If we consider as positive only those who received a scoliosis diagnosis during adolescence, the OR would be 3.15 (95% CI 1.55–6.42).

Discussion

This is the first study performed on patients with AN showing a sixfold greater odds of presenting with scoliosis. A cause–effect relationship cannot be determined due to the design.

Keywords

Scoliosis Anorexia Adolescent Idiopathic 

Notes

Acknowledgements

The authors are indebted to the all the staff, including MDs, nurses, psychologists, and nutritionists, involved in the management of AN in the Division of Eating Disorders at the Istituto Auxologico Italiano. This research was partially supported by funds of the Istituto Auxologico Italiano and of the Italian Ministry for University and Research, Rome, Italy (FIRB Grant: RBFR12DELS_004).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. 1.
    Hresko MT (2013) Clinical practice. Idiopathic scoliosis in adolescents. N Engl J Med 368:834–841. doi: 10.1056/NEJMcp1209063 CrossRefPubMedGoogle Scholar
  2. 2.
    Walters EE, Kendler KS (1995) Anorexia nervosa and anorexic-like syndromes in a population-based female twin sample. Am J Psychiatry 152:64–71CrossRefPubMedGoogle Scholar
  3. 3.
    Weinstein SL, Dolan LA, Spratt KF et al (2003) Health and function of patients with untreated idiopathic scoliosis: a 50-year natural history study. J Am Med Assoc 289:559–567CrossRefGoogle Scholar
  4. 4.
    Smith FM, Latchford G, Hall RM et al (2002) Indications of disordered eating behaviour in adolescent patients with idiopathic scoliosis. J Bone Joint Surg Br 84:392–394CrossRefPubMedGoogle Scholar
  5. 5.
    Misra M, Klibanski A (2011) Bone health in anorexia nervosa. Curr Opin Endocrinol Diabetes Obes 18:376–382. doi: 10.1097/MED.0b013e32834b4bdc CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Pourabbas Tahvildari B, Erfani M-A, Nouraei H, Sadeghian M (2014) Evaluation of bone mineral status in adolescent idiopathic scoliosis. Clin Orthop Surg 6:180–184. doi: 10.4055/cios.2014.6.2.180 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Alborghetti A, Scimeca G, Costanzo G, Boca S (2007) The prevalence of eating disorders in adolescents with idiopathic scoliosis. Eat Disord 16:85–93. doi: 10.1080/10640260701773660 CrossRefGoogle Scholar
  8. 8.
    Zaina F, Donzelli S, Lusini M et al (2013) Adolescent idiopathic scoliosis and eating disorders: is there a relation? Results of a cross-sectional study. Res Dev Disabil 34:1119–1124. doi: 10.1016/j.ridd.2013.01.001 CrossRefPubMedGoogle Scholar
  9. 9.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  10. 10.
    Grivas TB, Wade MH, Negrini S et al (2007) SOSORT consensus paper: school screening for scoliosis. Where are we today? Scoliosis 2:17. doi: 10.1186/1748-7161-2-17 CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Zaina F, Atanasio S, Negrini S (2008) Clinical evaluation of scoliosis during growth: description and reliability. Stud Health Technol Inform 135:125–138PubMedGoogle Scholar
  12. 12.
    Bunnell WP (1993) Outcome of spinal screening. Spine 18:1572–1580CrossRefPubMedGoogle Scholar
  13. 13.
    Negrini S, Aulisa AG, Aulisa L et al (2012) 2011 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 7:3. doi: 10.1186/1748-7161-7-3 CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Ascani E, Salsano V, Giglio G (1977) The incidence and early detection of spinal deformities. A study based on the screening of 16,104 schoolchildren. Ital J Orthop Traumatol 3:111–117PubMedGoogle Scholar
  15. 15.
    Weinstein SL, Ponseti IV (1983) Curve progression in idiopathic scoliosis. J Bone Joint Surg Am 65:447–455CrossRefPubMedGoogle Scholar
  16. 16.
    Hebebrand J, Muller TD, Holtkamp K, Herpertz-Dahlmann B (2006) The role of leptin in anorexia nervosa: clinical implications. Mol Psychiatry 12:23–35. doi: 10.1038/sj.mp.4001909 CrossRefPubMedGoogle Scholar
  17. 17.
    Tam EMS, Yu FWP, Hung VWY et al (2014) Are volumetric bone mineral density and bone micro-architecture associated with leptin and soluble leptin receptor levels in adolescent idiopathic scoliosis? A case–control study. PLoS One. doi: 10.1371/journal.pone.0087939 Google Scholar
  18. 18.
    Machida M, Dubousset J, Yamada T, Kimura J (2009) Serum melatonin levels in adolescent idiopathic scoliosis prediction and prevention for curve progression–a prospective study. J Pineal Res 46:344–348. doi: 10.1111/j.1600-079X.2009.00669.x CrossRefPubMedGoogle Scholar
  19. 19.
    Ostrowska Z, Ziora K, Oświęcimska J et al (2013) Assessment of the relationship between melatonin, hormones of the pituitary-ovarian, -thyroid and -adrenocortical axes, and osteoprotegerin and its ligand sRANKL in girls with anorexia nervosa. Postȩpy Hig Med Dośw Online 67:433–441. doi: 10.5604/17322693.1050027 CrossRefPubMedGoogle Scholar
  20. 20.
    Szalay EA, Bosch P, Schwend RM et al (2008) Adolescents with idiopathic scoliosis are not osteoporotic. Spine 33:802–806. doi: 10.1097/BRS.0b013e318169578f CrossRefPubMedGoogle Scholar
  21. 21.
    Eriksen SA, Prietzel H, Ibsen JR et al (2014) Bone and vitamin D status in patients with anorexia nervosa. Dan Med J 61:A4940PubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.ISICO (Italian Scientific Spine Institute)MilanItaly
  2. 2.Division of Eating DisordersIRCCS Istituto Auxologico ItalianoMilanItaly
  3. 3.Department of Clinical Sciences and Community HealthUniversity of MilanMilanItaly
  4. 4.Rehabilitation UnitIstituto Auxologico Italiano IRCCSPiancavalloItaly
  5. 5.Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
  6. 6.IRCCS Don Gnocchi FoundationMilanItaly

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