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FRI0560 Predictors of fractures in female patients with anorexia

Background Anorexia Nervosa (AN) is an eating disorder characterised by extremely low body weight and body image distortion. It is more common in females and is expected to become increasingly more prevalent. Numerous studies have found AN to have a detrimental effect on bone health. The evidence shows that anorexia is associated with reduced bone mass and strength which increases fracture risk. Few staudes have looked at other predictors of fracture in these patients. Objectives The aim of this study was to determine whether further predictors of fracture could be found in female patients suffering from anorexia nervosa (AN). Methods Female patients with anorexia refereed for a bone mineral density (BMD) DEXA scan from June 2006 to October 2014 were identified. This cohort of patients was split into two subgroups depending on their fracture status. Demographics collected on scanning and factors such as age at DEXA scan, height, weight, body fat percentage, BMI, lumbar spine L1-L4 BMD and femoral neck BMD were used to compare the fracture group against the controls. Categorical variables such as smoking, comorbidities (Rheumatoid arthritis), alcohol, family history and steroid use were compared using chi squared test and the T test was used tompare continous variables. Logistic regression models were used to model fractures unadjusted and adjusting for age at scan. Results A total of 193 female patients with anorexia were included: 45 (23.3%) had sustained a fracture. The results of statistical analysis are shown in Table 1. The data showed there is a significant association with having a low femoral neck BMD and increased fracture risk OR 0.036 (95%, CI 0.003, 0.497). The case group was also significantly taller OR 1.061 (95%, CI 1.009, 1.117) and older P value 0.0027 (95% combined CI 39.193, 42.682). There was no correlation with any of the categorical variables and fracture risk, see Table 2 for results.Table 1. Results of statistical analysis of continuous variables Characteristic Significance (P value) Cases with fractures Control group Age at scan (years) 0.0027 45.71 ±SD10.36 39.49 ± SD12.46 Height (cm) 0.021 165.08 ± SD7.45 162.66 ± SD6.82 Weight (kg) 0.129 58.16 ± SD13.68 53.73 ± SD11.83 Body Fat (%) 0.536 16.36 ± SD11.75 13.62 ± SD10.28 BMI 0.601 21.24 ± SD4.31 20.31 ± SD4.43 Lumbar spine (L1-L4) (g/cm2) 0.053 0.98 ± SD0.18 1.03 ± SD0.14 Femoral neck BMD (g/cm2) 0.013 0.81±SD0.15 0.86±SD0.14Table 2. Results of statistical analysis of categorical variables Characteristic Cases with fracture (45) Control group (148) Significance (P value) Smoker 28.9% (13) 34.46% (51) 0.445 RA 2.22% (1) 0.68% (1) 0.349 Alcohol 8.89% (4) 8.78% (13) 0.524 Family history 31.11% (14) 22.97% (34) 0.403 Steroid 15.56% (7) 8.78% (13) 0.197 Conclusions This study demonstrates that fractures in female patients with anorexia are more likely to occur in those who are taller, older at DEXA scan and in those who have a lower femoral neck BMD. This would inidcate that cortiocal bone loss and taller stature are indepent risks in this cohort. Further work using vitamin D levels as a risk should be performed. Disclosure of Interest None declared