Grinspoon S, Thomas E, Pitts S, Gross E, Mickley D, Miller K, Herzog D, Klibanski A
Neuroendocrine Unit, Bulfinch 457b, Massachusetts General Hospital, Boston, MA 02114, USA.
Ann Intern Med. 2000 Nov 21;133(10):790-4. doi: 10.7326/0003-4819-133-10-200011210-00011.
Anorexia nervosa is highly prevalent among young women.
To determine prevalence and predictive factors for regional bone loss.
Prospective cohort analysis.
University hospital.
130 women with anorexia nervosa.
Dual-energy x-ray absorptiometry.
The prevalence of osteopenia (-1.0 SD >/= T-score > -2.5 SD) and osteoporosis (T-score </= -2.5 SD) was 50% and 13% for the anterior-posterior spine, 57% and 24% for the lateral spine, and 47% and 16% for the total hip, respectively. Bone mineral density (BMD) was reduced by at least 1.0 SD at one or more skeletal sites in 92% of patients and by at least 2.5 SD in 38% of patients. Weight was the most consistent predictor of BMD at all skeletal sites. Twenty-three percent of patients were current estrogen users, and 58% were previous estrogen users. Bone mineral density did not differ by history of estrogen use at any site.
Bone mineral density is reduced at several skeletal sites in most women with anorexia nervosa. Weight, but not estrogen use, is a significant predictor of BMD in this population at all skeletal sites.
神经性厌食症在年轻女性中极为普遍。
确定区域骨质流失的患病率及预测因素。
前瞻性队列分析。
大学医院。
130名神经性厌食症女性患者。
双能X线吸收法。
前后位脊柱骨质减少（-1.0标准差≥T值＞-2.5标准差）和骨质疏松（T值≤-2.5标准差）的患病率分别为50%和13%，侧位脊柱分别为57%和24%，全髋分别为47%和16%。92%的患者在一个或多个骨骼部位骨矿物质密度（BMD）至少降低1.0标准差，38%的患者至少降低2.5标准差。体重是所有骨骼部位BMD最一致的预测因素。23%的患者目前使用雌激素，58%的患者曾使用过雌激素。在任何部位，BMD在雌激素使用史方面并无差异。
大多数神经性厌食症女性患者的多个骨骼部位骨矿物质密度降低。在该人群中，体重而非雌激素使用情况是所有骨骼部位BMD的重要预测因素。
