Neuroendocrine and Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA.
J Clin Endocrinol Metab. 2013 Jul;98(7):2952-8. doi: 10.1210/jc.2013-1457. Epub 2013 May 7.
We have reported lower hip bone mineral density (BMD) in adolescent boys with anorexia nervosa (AN) compared with controls. Although studies have described bone structure in girls with AN, these data are not available for boys. Hip structural analysis (HSA) using dual-energy x-ray absorptiometry is a validated technique to assess hip geometry and strength while avoiding radiation associated with quantitative computed tomography.
We hypothesized that boys with AN would have impaired hip structure/strength (assessed by HSA) compared with controls.
We conducted a cross-sectional study at a clinical research center.
We used HSA techniques on hip dual-energy x-ray absorptiometry scans in 31 previously enrolled boys, 15 with AN and 16 normal-weight controls, 12 to 19 years old.
AN boys had lower body mass index SD score (P < .0001), testosterone (P = .0005), and estradiol (P = .006) than controls. A larger proportion of AN boys had BMD Z-scores <-1 at the femoral neck (60% vs 12.5%, P = 0008). Using HSA, at the narrow neck and trochanter region, boys with AN had lower cross-sectional area (P = .03, 0.02) and cortical thickness (P = .02, 0.03). Buckling ratio at the trochanter region was higher in AN (P = .008). After controlling for age and height, subperiosteal width at the femoral shaft, cross-sectional moment of inertia (narrow neck and femoral shaft), and section modulus (all sites) were lower in AN. The strongest associations of HSA measures were observed with lean mass, testosterone, and estradiol. On multivariate analysis, lean mass remained associated with most HSA measures.
Boys with AN have impaired hip geometric parameters, associated with lower lean mass.
我们曾报道过患有神经性厌食症（AN）的青少年男性的髋部骨矿物质密度（BMD）低于对照组。尽管已有研究描述了患有 AN 的女性的骨骼结构，但这些数据不适用于男性。双能 X 射线吸收法的髋关节结构分析（HSA）是一种评估髋关节几何形状和强度的有效技术，同时避免了与定量计算机断层扫描相关的辐射。
我们假设与对照组相比，患有 AN 的男性的髋部结构/强度（通过 HSA 评估）受损。
我们在一个临床研究中心进行了一项横断面研究。
我们使用 HSA 技术对 31 名先前入组的 12 至 19 岁男孩的髋部双能 X 射线吸收法扫描进行了分析，其中 15 名患有 AN，16 名体重正常。
患有 AN 的男性的体重指数 SD 评分较低（P <.0001），睾酮（P =.0005）和雌二醇（P =.006）也低于对照组。更大比例的 AN 男性的股骨颈 BMD Z 评分<-1（60%比 12.5%，P = 0008）。使用 HSA，在狭窄的颈部和转子区域，患有 AN 的男性的横截面积较小（P =.03，0.02），皮质厚度较小（P =.02，0.03）。转子区域的屈曲比在 AN 中较高（P =.008）。在控制年龄和身高后，股骨干的骨膜下宽度、横截面惯性矩（狭窄颈部和股骨干）和截面模数（所有部位）在 AN 中较低。HSA 测量值的最强相关性是与瘦体重、睾酮和雌二醇观察到的。在多变量分析中，瘦体重仍然与大多数 HSA 测量值相关。
患有 AN 的男性髋部几何参数受损，与瘦体重较低有关。
