Haagensen A L, Feldman H A, Ringelheim J, Gordon C M
Division of Endocrinology, Children's Hospital Boston, Boston, USA.
Osteoporos Int. 2008 Mar;19(3):289-94. doi: 10.1007/s00198-007-0476-z. Epub 2007 Oct 9.
Fifty adolescents with AN and 200 healthy girls underwent vitamin D screening. Girls with AN reported exceptional compliance with vitamin D supplementation and PTH concentrations were lower. Vitamin D deficiency was less common in the group with AN, but when race was considered, the trend was no longer significant.
The objective of this study was to determine whether patients with anorexia nervosa (AN) are more compliant with supplementation and have a lower prevalence of vitamin D deficiency than healthy controls.
Fifty adolescents with AN and 200 controls were compared using anthropometric and lifestyle data, serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) concentrations, and prevalence of vitamin D deficiency.
The prevalence of deficiency (<20 ng/mL) was 2% in the AN group vs. 24% among controls (p = 0.003). 25OHD was similar among white participants with AN and white controls (39.5 vs. 36.0 ng/mL, p = 0.20), but higher than in non-white controls (20.6 ng/mL). Significantly more girls with AN reported vitamin D supplementation (86%) than the full control (14%) or white subgroup (27%) (p < 0.001). Participants with AN had lower PTH concentrations than controls, (27.8 vs. 47.4 pg/mL, p = 0.009), a trend that lost significance after age and race adjustment (41.7 pg/mL, p = 0.12).
Compared to healthy controls, adolescents with AN had a lower prevalence of vitamin D deficiency and PTH concentration. However, 25OHD and PTH concentrations were similar after adjustment for race and age. The trend of lower PTH levels in adolescents with AN, accompanied by exceptional compliance with supplementation, may have bone health implications for these patients.
五十名患有神经性厌食症(AN)的青少年和200名健康女孩接受了维生素D筛查。患有AN的女孩报告称对维生素D补充剂的依从性极佳,且甲状旁腺激素(PTH)浓度较低。维生素D缺乏在AN组中不太常见,但在考虑种族因素后,这种趋势不再显著。
本研究的目的是确定神经性厌食症(AN)患者是否比健康对照组更依从补充剂治疗且维生素D缺乏的患病率更低。
使用人体测量和生活方式数据、血清25-羟基维生素D(25OHD)和甲状旁腺激素(PTH)浓度以及维生素D缺乏的患病率,对五十名患有AN的青少年和200名对照组进行比较。
AN组中缺乏(<20 ng/mL)的患病率为2%,而对照组为24%(p = 0.003)。患有AN的白人参与者和白人对照组的25OHD相似(39.5对36.0 ng/mL,p = 0.20),但高于非白人对照组(20.6 ng/mL)。报告补充维生素D的患有AN的女孩(86%)明显多于全部对照组(14%)或白人亚组(27%)(p < 0.001)。患有AN的参与者的PTH浓度低于对照组(27.8对47.4 pg/mL,p = 0.009),在年龄和种族调整后这种趋势失去显著性(41.7 pg/mL,p = 0.12)。
与健康对照组相比,患有AN的青少年维生素D缺乏和PTH浓度的患病率较低。然而,在调整种族和年龄后,25OHD和PTH浓度相似。患有AN的青少年PTH水平较低的趋势,伴随着对补充剂的极佳依从性,可能对这些患者的骨骼健康有影响。