Percentage body fat by dual-energy X-ray absorptiometry is associated with menstrual recovery in adolescents with anorexia nervosa.

PURPOSE: To evaluate mediators of resumption of menses (ROM) in adolescents with anorexia nervosa (AN).

METHODS

Anthropometrics, body composition by dual-energy X-ray absorptiometry, hormonal studies, and responses to mental health screens were obtained at 6-month intervals for 18 months in 37 adolescents with AN randomized to the placebo arm of a double-blind treatment trial. Outcomes were compared between subjects with menstrual recovery and those without.

RESULTS

Twenty-four subjects (65%) had ROM. Higher percentage body fat was associated with ROM (odds ratio, 1.19; 95% confidence interval, 1.06, 1.33; p < .01), as was body mass index and percent median body weight. Estradiol ≥30 ng/mL alone did not predict menses (p = .08) but was associated with ROM when coupled with percent mean body weight (odds ratio, 2.49; 95% confidence interval, 1.09, 5.65; p = .03). Changes in leptin, cortisol, and mental health were not associated with return of menses.

CONCLUSIONS

Percentage body fat may be an additional, useful clinical assessment to follow in caring for adolescents with AN.