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. 2022 Dec;27(8):3207-3213.
doi: 10.1007/s40519-022-01450-2. Epub 2022 Jul 28.

Radiofrequency echographic multispectrometry (REMS): an innovative technique for the assessment of bone status in young women with anorexia nervosa

Carla Caffarelli  1 , Antonella Al Refaie  2 , Michela De Vita  2 , Maria Dea Tomai Pitinca  2 , Arianna Goracci  3 , Andrea Fagiolini  3 , Stefano Gonnelli  2
Affiliations

Radiofrequency echographic multispectrometry (REMS): an innovative technique for the assessment of bone status in young women with anorexia nervosa

Carla Caffarelli et al. Eat Weight Disord. 2022 Dec.

Abstract

Purpose: Reduced bone mineral density (BMD) and increase risk of fragility fracture are common complication of anorexia nervosa (AN). BMD by dual-energy X-ray absorptiometry (DXA) present several limits in subjects with AN. This study aimed to evaluate the usefulness of the new Radiofrequency echographic multispectrometry (REMS) technique in the assessment of bone status in young women with AN.

Methods: In a cohort of 50 subjects with restrictive AN and in 30 healthy controls, we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using both DXA and REMS technique.

Results: BMD evaluated by DXA and REMS technique at all measurement sites were all significantly (p < 0.01) lower in subjects suffering from AN subjects than in controls. Good correlations were detected between BMD by DXA and BMD by REMS measurements at LS (r = 0.64, p < 0.01) at FN (r = 0.86, p < 0.01) and at TH (r = 0.84, p < 0.01) in subjects suffering from AN. Moreover, Bland-Altman analysis confirmed the good agreement between the two techniques. The subjects suffering from AN with previous vertebral fragility fractures presented lower values of both BMD-LS and BMD-TH by DXA and by REMS with respect to those without fractures; however, the difference was significant only for BMD-TH by REMS (p < 0.05).

Conclusions: Our data suggest that REMS technique due to its characteristic of precision and reproducibility may represent an important tool for the evaluation of the changes in bone status in AN young women, especially during the fertile age and in case of pregnancy and breastfeeding.

Level of evidence: Level of evidence: level III cohort study.

Keywords: Anorexia nervosa; Bone mineral density; Dual-energy X-ray absorptiometry (DXA); Osteoporosis; Radiofrequency echographic multispectrometry (REMS).

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Conflict of interest statement

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Schematic representation of Radiofrequency echographic multispectrometry (REMS) acquisition on femoral neck
Fig. 2
Fig. 2
Values of BMD expressed as Z-score at lumbar spine (LS), at femoral neck (FN) and at total hip (TH) by DXA and REMS technique in young women with anorexia nervosa
Fig. 3
Fig. 3
Bland–Altman plot for comparison of BMD by REMS and BMD by DXA measurements for young women with anorexia nervosa at lumbar spine (A) and at total hip (B)
Fig. 4
Fig. 4
BMD-LS (A) and BMD-TH (B) by DXA and REMS technique in young women with anorexia nervosa with fracture or without vertebral fracture
See this image and copyright information in PMC

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