Wiksten-Almströmer Marianne, Hirschberg Angelica Lindën, Hagenfeldt Kerstin
Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Stockholm, Sweden.
Acta Obstet Gynecol Scand. 2009;88(5):543-9. doi: 10.1080/00016340902846080.
To evaluate the long-term effects on bone mineral density (BMD) in women diagnosed with menstrual disorders in their adolescence.
Prospective follow-up study six years after the initial investigation.
A youth clinic that is part of the school health system in Stockholm.
Eighty-seven women diagnosed with secondary amenorrhea or oligomenorrhea in adolescence.
Subjects underwent gynecological examination, evaluation of eating behavior and physical activity. Whole body Dual Energy X-ray Absorptiometry was used for measurement of BMD.
BMD.
The overall frequency of osteopenia/osteoporosis was 52%, and three girls had osteoporosis. Women with previous secondary amenorrhea had significantly lower BMD in the pelvis and lumbar spine than those with previous oligomenorrhea. The strongest predictor of low BMD was a restrictive eating disorder in adolescence and the most important counteraction was high physical activity at follow-up and a body mass index (BMI) > or = 22. Persistent menstrual dysfunction at follow-up was associated with polycystic ovary syndrome and lower frequency of osteopenia.
This clinical follow-up study has demonstrated a high frequency of osteopenia in women diagnosed with menstrual disorders in adolescence. Previous anorectic behavior was the strongest negative predictor of BMD. It is important to pay attention to an underlying eating disorder in young women with menstrual dysfunction in order to promote bone health.
评估青春期被诊断为月经紊乱的女性骨矿物质密度（BMD）的长期影响。
在初次调查6年后进行的前瞻性随访研究。
斯德哥尔摩学校卫生系统下属的一家青少年诊所。
87名在青春期被诊断为继发性闭经或月经过少的女性。
研究对象接受了妇科检查、饮食行为和身体活动评估。采用全身双能X线吸收法测量骨矿物质密度。
骨矿物质密度。
骨质减少/骨质疏松的总体发生率为52%，3名女孩患有骨质疏松症。既往有继发性闭经的女性骨盆和腰椎的骨矿物质密度显著低于既往有月经过少的女性。骨矿物质密度低的最强预测因素是青春期的限制性饮食失调，最重要的对抗措施是随访时的高身体活动量和体重指数（BMI）≥22。随访时持续的月经功能障碍与多囊卵巢综合征及较低的骨质减少发生率相关。
这项临床随访研究表明，青春期被诊断为月经紊乱的女性中骨质减少的发生率很高。既往的厌食行为是骨矿物质密度最强的负面预测因素。关注月经功能障碍年轻女性潜在的饮食失调对于促进骨骼健康很重要。
