Pumarino H, Ventura M, Solís I, Lillo R, Oviedo S, López D
Departamento de Medicina, Hospital José Joaquín Aguirre, Santiago de Chile.
Rev Med Chil. 1992 Mar;120(3):275-81.
30 female patients with anorexia nervosa (AN) were studied and compared with 45 age-matched normal controls. All the patients had severe weight loss and nutritional involvement. Mean and SE body mass index, BMI (kg/m2) were 15.8 +/- 1.8 in anorectics compared to 21.7 +/- 4.7 in normals (p < 0.0001). All the patients presented amenorrhea lasting between 3 and 120 months (mean 24.8 +/- 25.3). A nutritional survey and a dual photon bone densitometry, including spine, hip, total body and total mineral content were performed. The mean values +/- SE in patients and controls were: spine densities (L2-L4) in g/cm2: AN 0.84 +/- 0.1, controls 1.03 +/- 0.1 (p < 0.002). Total mineral content (g): AN mean 1733 +/- 261, controls 2045 +/- 276 (p < 0.0001). In anorectic patients the correlations between bone density and BMI for spine were r: 0.52 (p = 0.002), for hip r: 0.37 (p = 0.04), and total mineral content vs BMI gave r: 0.64 (p = 0.0001). Mean calcium intake in 23 studied patients was lesser than the classic recommended dietary allowance in the whole group, it was less in the pure restricters as compared to vomiters. The relation between duration of amenorrhea and bone density showed than a decrease in the later was evident when the absence of menses was longer than 24 months. In conclusion, in patients with AN there is a real decrease in bone density which is strongly related to low weight and in lesser proportion to the duration of amenorrhea, particularly when it was longer than 24 month.
对30名神经性厌食症(AN)女性患者进行了研究,并与45名年龄匹配的正常对照者进行比较。所有患者均有严重体重减轻和营养问题。厌食症患者的平均体重指数(BMI,kg/m²)及标准误为15.8±1.8,而正常对照者为21.7±4.7(p<0.0001)。所有患者均出现闭经,持续时间为3至120个月(平均24.8±25.3)。进行了营养调查和双能光子骨密度测定,包括脊柱、髋部、全身和总矿物质含量。患者和对照者的平均值及标准误如下:脊柱密度(L2-L4,g/cm²):AN组为0.84±0.1,对照组为1.03±0.1(p<0.002)。总矿物质含量(g):AN组平均为1733±261,对照组为2045±276(p<0.0001)。在厌食症患者中,脊柱骨密度与BMI的相关性r为0.52(p=0.002),髋部r为0.37(p=0.04),总矿物质含量与BMI的相关性r为0.64(p=0.0001)。23名研究患者的平均钙摄入量低于整个组的经典推荐膳食摄入量,纯节食者的钙摄入量低于催吐者。闭经持续时间与骨密度的关系表明,当闭经时间超过24个月时,骨密度明显下降。总之,AN患者存在骨密度真正下降,这与低体重密切相关,与闭经持续时间的相关性较小,尤其是闭经时间超过24个月时。