Bone health assessment in patients with Anorexia Nervosa and Bulimia Nervosa

Abstract

Eating Disorders (ED) are psychiatric conditions and clinical complications resulting from their typical symptoms such as food restriction, excessive physical exercise, and compensatory methods as induction of vomiting and abuse of laxatives and diuretics are the major causes for clinical complications and death. Changes and intense losses in bone mineral density increase the risk of women with Anorexia Nervosa and Bulimia Nervosa suffering fractures, developing osteoporosis and osteopenia - whose main factors are low weight, low physical activity, history and duration of the disease, amenorrhea, strength muscle dysfunction, vitamin D insufficiency and hypercalcemia. The only Brazilian studies that evaluated BMD in Ed were conducted with adolescents or with a restricted sample, and this topic of clinical relevance is little explored in the country. Objective: To evaluate bone health regarding: body composition, bone mineral density, serum vitamin D concentrations, hormones and markers of bone metabolism in women with Anorexia Nervosa and Bulimia Nervosa. Method: adult women between 18 and 49 years old in current or previous treatment in the Eating Disorders Program of the Institute of Psychiatry of the Clinical Hospital of the Medicine School of the University of São Paulo (AMBULIM) will be invited to participate in the research. Demographic, socioeconomic, nutritional status, lifestyle, clinical history of the disease, calcium intake, vitamin D and supplements and physical activity will be collected; And for bone health there will be blood collection, anthropometry and dual-beam absorptiometry (DXA) densitometry. Bone health data will be evaluated in relation to the diagnosis (current or previous Anorexia and Bulimia), age, nutritional status, years of illness, compensatory methods, medications used, menstrual cycle, parity and physical activity. Descriptive statistical analysis of the data, presented in mean and standard deviation, median and interquartile range or frequencies (%) will be performed. All continuous variables will have their distribution evaluated using the Shapiro-Wilk test. The SPSS 20.0 (SPSS Inc., Chicago IL, USA) software will be used and the significance level adopted will be 5% and the sample size is 106 subjects. (AU)