Seeman E, Szmukler G I, Formica C, Tsalamandris C, Mestrovic R
Department of Endocrinology, Austin Hospital, Melbourne, Australia.
J Bone Miner Res. 1992 Dec;7(12):1467-74. doi: 10.1002/jbmr.5650071215.
Anorexia nervosa occurs early in life and predisposes to osteoporosis. Exercise may be protective. We asked: (1) Does failure to attain peak bone density contribute to the deficit in bone density? (2) Does oral contraceptive use protect against osteoporosis? (3) Is any protective effect of exercise confined to weight-bearing sites? Areal bone density (g/cm2) and body composition were measured by dual x-ray absorptiometry in 65 patients with anorexia nervosa and 52 controls. Comparing the 12 patients with primary amenorrhea and the 37 patients with secondary amenorrhea, bone density (mean +/- SEM) at the lumbar spine was 0.88 +/- 0.04 versus 1.06 +/- 0.03 (P = 0.001), respectively. Bone density at the femoral neck was 0.80 +/- 0.04 versus 0.92 +/- 0.03 (P < 0.05), respectively. These values differed before, but not after, adjusting for the respective duration of illness (73.0 +/- 10.3 versus 34.1 +/- 4.8 months, P < 0.001) and fat-free mass (31.6 +/- 1.3 versus 35.4 +/- 0.5 kg, P < 0.01). Bone density at the lumbar spine in the 16 patients with 31.8 +/- 8.3 months of contraceptive exposure was higher than in the 49 patients with no contraceptive exposure (1.14 +/- 0.05 versus 1.02 +/- 0.02 P < 0.02) but was lower than in controls (1.14 +/- 0.05 versus 1.27 +/- 1.02, P < 0.01). No protective effect of contraceptive exposure was detectable at the femoral neck.(ABSTRACT TRUNCATED AT 250 WORDS)
神经性厌食症发病较早，易引发骨质疏松。运动可能具有保护作用。我们提出以下问题：（1）未能达到峰值骨密度是否会导致骨密度不足？（2）使用口服避孕药能否预防骨质疏松？（3）运动的任何保护作用是否仅限于负重部位？通过双能X线吸收法对65例神经性厌食症患者和52例对照者进行了面积骨密度（g/cm²）和身体成分测量。比较12例原发性闭经患者和37例继发性闭经患者，腰椎骨密度（均值±标准误）分别为0.88±0.04和1.06±0.03（P = 0.001）。股骨颈骨密度分别为0.80±0.04和0.92±0.03（P < 0.05）。在根据各自病程（73.0±10.3对34.1±4.8个月，P < 0.001）和去脂体重（31.6±1.3对35.4±0.5 kg，P < 0.01）进行调整之前，这些值存在差异，但调整后差异消失。16例有31.8±8.3个月避孕药暴露史的患者腰椎骨密度高于49例无避孕药暴露史的患者（1.14±0.05对1.02±0.02，P < 0.02），但低于对照组（1.14±0.05对1.27±1.02，P < 0.01）。在股骨颈未检测到避孕药暴露的保护作用。（摘要截断于250字）
