神经性厌食症患者骨质疏松症的筛查：骨矿物质密度降低的患病率及预测因素

Screening for osteoporosis in anorexia nervosa: prevalence and predictors of reduced bone mineral density.

作者信息

Winston Anthony P, Alwazeer Ahmed E F, Bankart Michael J G

机构信息

Eating Disorders Unit, Woodleigh Beeches Centre, Warwick Hospital, Warwick, United Kingdom.

出版信息

Int J Eat Disord. 2008 Apr;41(3):284-7. doi: 10.1002/eat.20501.

DOI:10.1002/eat.20501

PMID:18176948

Abstract

OBJECTIVE

Decreased bone mineral density (BMD) in anorexia nervosa (AN) can be detected easily by dual-energy X-ray absorptiometry (DXA). This study was designed to assess the prevalence of osteoporosis and osteopenia in AN, identify predictors, and determine the diagnostic yield of screening with DXA.

METHOD

DXA was used to screen 59 unselected adult patients with a history of AN.

RESULTS

Osteoporosis was identified in 18 patients (31%) and osteopenia in 30 (51%). The spine had a lower mean T-score than either the hip or femur. BMI significantly predicted T-score (p = 0.0006) and the odds of having osteoporosis (p = 0.0188). There was a significant association between use of oestrogens and the presence of osteoporosis or osteopenia (p = 0.0491). There was no significant association between duration of AN and T-score. A duration of AN of less than 1 year was found in 12% of those with osteoporosis.

CONCLUSION

BMI is a strong predictor of BMD in AN. DXA is an effective screening tool and should probably be offered routinely.

摘要

目的

通过双能X线吸收法（DXA）能够轻易检测出神经性厌食症（AN）患者骨矿物质密度（BMD）降低的情况。本研究旨在评估AN患者中骨质疏松症和骨质减少的患病率，确定预测因素，并测定DXA筛查的诊断率。

方法

采用DXA对59例无特定选择的有AN病史的成年患者进行筛查。

结果

18例患者（31%）被诊断为骨质疏松症，30例（51%）为骨质减少。脊柱的平均T值低于髋部或股骨。体重指数（BMI）显著预测T值（p = 0.0006）以及患骨质疏松症的几率（p = 0.0188）。雌激素的使用与骨质疏松症或骨质减少的存在之间存在显著关联（p = 0.0491）。AN的病程与T值之间无显著关联。在12%的骨质疏松症患者中，AN病程少于1年。