ArticleJournal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research2017
Assessment of Sex Differences in Fracture Risk Among Patients With Anorexia Nervosa: A Population-Based Cohort Study Using The Health Improvement Network.
Article in Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 2 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- The impact of physical activity interventions on body composition and quality of life in adolescents with anorexia nervosa: a meta-analysis of randomized controlled trials.BMC pediatrics · 2025Pooled it
- Medical Management of Restrictive Eating Disorders in Adolescents and Young Adults.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2022Guideline
- Effects of teriparatide on hip structure and bone microarchitecture in women with anorexia nervosa: a placebo-controlled randomized trial.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Trial
- Weight loss induced bone loss: mechanism of action and clinical implications.Bone research · 2025Review
- A Critical Assessment of Fasting to Promote Metabolic Health and Longevity.Endocrine reviews · 2025Review
- Bone Fracture History in Women With First Episode or With Persistent Anorexia Nervosa.European eating disorders review : the journal of the Eating Disorders Association · 2025Article
- Intermittent fasting for systemic triglyceride metabolic reprogramming (IFAST): Design and methods of a prospective, randomized, controlled trial.Contemporary clinical trials · 2024Article
- Methionine as a regulator of bone remodeling with fasting.JCI insight · 2024Article
- Deficits in volumetric bone mineral density, bone microarchitecture, and estimated bone strength in women with atypical anorexia nervosa compared to healthy controls.The International journal of eating disorders · 2024Article
- Neuroendocrine adaptations to starvation.Psychoneuroendocrinology · 2023Review
- Endocrine complications of anorexia nervosa.Journal of eating disorders · 2023Review
- Bone marrow adipose tissue is associated with fracture history in anorexia nervosa.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022Article
- Estrogen for the Treatment of Low Bone Mineral Density in Anorexia Nervosa.Journal of psychiatry and brain science · 2022Article
- Bone health in functional hypothalamic amenorrhea: What the endocrinologist needs to know.Frontiers in endocrinology · 2022Review
- Eating disorders in adolescent boys and young men: an update.Current opinion in pediatrics · 2020Review
- Anorexia Nervosa with Markedly High Bone Turnover and Hyperphosphatemia During Refeeding Rectified by Denosumab.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- IGF-1 is associated with estimated bone strength in anorexia nervosa.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2020Article
- Article
- Associations between exercise, bone mineral density, and body composition in adolescents with anorexia nervosa.Eating and weight disorders : EWD · 2019Article
- Intertrochanteric fracture with low-energy trauma in a young woman with anorexia nervosa: A case report.Medicine · 2019Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
Though previous studies have demonstrated an increased fracture risk in females with anorexia nervosa (AN), fracture risk in males is not well characterized. The objective of this study was to examine sex differences in fracture risk and site-specific fracture incidence in AN. We performed a population-based retrospective cohort study using The Health Improvement Network (THIN; a large database of anonymized electronic medical records collected at primary care clinics throughout the United Kingdom). The median calendar year for the start of the observation period was 2004-2005. We identified 9239 females and 556 males <60 years of age with AN, and 97,889 randomly selected sex-, age-, and practice-matched participants without eating disorders (92,329 females and 5560 males). Multivariable Cox regression was used to estimate the hazard ratio (HR) for incident fracture. Median age at start of observation was 29.8 years in females and 30.2 years in males. The HR for fracture associated with AN differed by sex and age (interaction p = 0.002). Females with AN had an increased fracture risk at all ages (HR, 1.59; 95% confidence interval [CI], 1.45 to 1.75). AN was associated with a higher risk of fracture among males >40 years of age (HR, 2.54; 95% CI, 1.32 to 4.90; p = 0.005) but not among males ≤40 years. Females with AN had a higher risk of fracture at nearly all anatomic sites. The greatest excess fracture risk was noted at the hip/femur (HR, 5.59; 95% CI, 3.44 to 9.09) and pelvis (HR, 4.54; 95% CI, 2.42 to 8.50) in females and at the vertebrae (HR, 7.25; 95% CI, 1.21 to 43.45) for males with AN. AN was associated with higher incident fracture risk in females across all age groups and in males >40 years old. Sites of highest fracture risk include the hip/femur and pelvis in females and vertebrae in males with AN. © 2016 American Society for Bone and Mineral Research.
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