Horst-Sikorska Wanda, Ignaszak-Szczepaniak Magdalena
Katedra i Zakład Medycyny Rodzinnej, Uniwersytet Medyczny, Poznań.
Endokrynol Pol. 2011;62 Suppl 3:1-3.
Anorexia nervosa (AN) has in recent years become considerably more common. The disease primarily affects girls and young women, also boys and young men. AN is a risk factor for secondary osteoporosis. AN-related metabolic disturbances lead to diminished bone quality and increased risk of fractures. The consequences of low energy fractures are the main causes of death in women with AN. Hormonal disturbances (e.g. hypoestrogenism, increased levels of ghrelin and Y peptide, changes in leptin and endocannabinoid levels), as well as the mechanisms involved in bone resorption (RANK/RANKL/OPG system), are considered to be of great importance for anorectic bone quality. The risk for osteoporotic, non-vertebral fractures in AN patients is significantly higher than in healthy women. Improvement of bone mineral density is possible after substantial body mass increase. Weight loss, in conjunction with a well-balanced, controlled diet, is the key to correct peak bone mass levels, and diminishes the risk for osteoporosis with its consequence of low energy bone fractures.
近年来，神经性厌食症（AN）变得相当普遍。该疾病主要影响女孩和年轻女性，也包括男孩和年轻男性。AN是继发性骨质疏松症的一个危险因素。与AN相关的代谢紊乱会导致骨质下降和骨折风险增加。低能量骨折的后果是AN女性患者死亡的主要原因。激素紊乱（如雌激素缺乏、胃饥饿素和Y肽水平升高、瘦素和内源性大麻素水平变化）以及骨吸收所涉及的机制（RANK/RANKL/OPG系统）被认为对厌食症患者的骨质非常重要。AN患者发生骨质疏松性非椎体骨折的风险明显高于健康女性。体重显著增加后，骨矿物质密度有可能得到改善。体重减轻，结合均衡、可控的饮食，是纠正峰值骨量水平的关键，并降低骨质疏松症及其导致的低能量骨折风险。
