Gordon Catherine M, Goodman Elizabeth, Emans S Jean, Grace Estherann, Becker Kelly A, Rosen Clifford J, Gundberg Caren M, Leboff Meryl S
Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, Massachusetts 02115, USA.
J Pediatr. 2002 Jul;141(1):64-70. doi: 10.1067/mpd.2002.125003.
To clarify the role of physiologic regulators of bone turnover in patients with anorexia nervosa (AN).
Adolescent girls with AN (n = 61) had anthropometric, nutrition, and exercise data acquired, and bone mineral density (BMD) and body composition measured by dual energy x-ray absorptiometry. Serum samples were obtained for hormones, proresorptive cytokines, and bone formation markers, and urine for bone resorption markers.
In bivariate correlation analyses, significant (P <.05) predictors of lumbar BMD included height, weight, and exercise. In multiple regression models, these significant relationships held, even after controlling for the duration of amenorrhea and AN. For total body BMD, the same positive predictors were found and percentage of body fat was a negative correlate. For hip BMD, exercise and weight were found to be positive predictors. Dehydroepiandrosterone sulfate (DHEAS) was inversely correlated with N-telopeptides (NTx), and insulin-like growth factor I (IGF-I) was directly correlated with osteocalcin. Proresorptive cytokine levels were low or undetectable.
Exercise and weight were positive predictors of BMD. These data are the first to suggest a relationship between DHEAS and increased bone resorption in AN. IGF-I was correlated with bone formation indices. Low cytokine levels suggest that these factors do not mediate the increased bone resorption of AN.
阐明骨转换生理调节因子在神经性厌食症（AN）患者中的作用。
对患有AN的青春期女孩（n = 61）进行人体测量、营养和运动数据采集，并通过双能X线吸收法测量骨矿物质密度（BMD）和身体成分。采集血清样本检测激素、促吸收细胞因子和骨形成标志物，采集尿液检测骨吸收标志物。
在双变量相关性分析中，腰椎BMD的显著（P <.05）预测因素包括身高、体重和运动。在多元回归模型中，即使在控制闭经和AN的持续时间后，这些显著关系依然成立。对于全身BMD，发现了相同的正向预测因素，且体脂百分比呈负相关。对于髋部BMD，运动和体重是正向预测因素。硫酸脱氢表雄酮（DHEAS）与N-端肽（NTx）呈负相关，胰岛素样生长因子I（IGF-I）与骨钙素呈正相关。促吸收细胞因子水平较低或无法检测到。
运动和体重是BMD的正向预测因素。这些数据首次表明AN中DHEAS与骨吸收增加之间存在关联。IGF-I与骨形成指标相关。低细胞因子水平表明这些因素并未介导AN中增加的骨吸收。
