Nagata Jason M, Golden Neville H, Peebles Rebecka, Long Jin, Murray Stuart B, Leonard Mary B, Carlson Jennifer L
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California; Department of Pediatrics, Division of Adolescent and Young Adult Medicine, University of California, San Francisco, San Francisco, California.
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
J Adolesc Health. 2017 Apr;60(4):455-459. doi: 10.1016/j.jadohealth.2016.11.005. Epub 2017 Jan 11.
To compare deficits in fat mass (FM) and lean body mass (LM) among male and female adolescents with anorexia nervosa (AN) and to identify other covariates associated with body composition.
We retrospectively reviewed electronic medical records of all subjects aged 9-20 years with a Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnosis of AN and dual-energy x-ray absorptiometry scans after initial evaluation at Stanford between March 1997 and February 2011. From the dual-energy x-ray absorptiometry scans, LM and FM results were converted to age-, height-, sex-, and race-specific Z-scores for age using the National Health and Nutrition Examination Survey reference data.
A total of 16 boys and 119 girls with AN met eligibility criteria. The FM Z-score in girls with AN (-3.24 ± 1.50) was significantly lower than that in boys with AN (-2.41 ± .96) in unadjusted models (p = .007). LM was reduced in both girls and boys with AN, but there was no significant sex difference in LM Z-scores. In multivariate models, lower percentage median body mass index was significantly associated with lower FM Z-scores (β = .08, p < .0001) and lower LM Z-score (β = .03, p = .0002), whereas lower whole body bone mineral content Z-score was significantly associated with lower LM Z-score (β = .21, p = .0006).
FM deficits in girls were significantly greater than those in boys with AN in unadjusted models; however, the degree of malnutrition appeared to be the primary factor accounting for this difference. There were no significant sex differences in FM or LM in adjusted models.
比较神经性厌食症（AN）男女青少年的脂肪量（FM）和瘦体重（LM）缺陷，并确定与身体成分相关的其他协变量。
我们回顾性分析了1997年3月至2011年2月在斯坦福大学初次评估后，所有年龄在9至20岁、符合《精神疾病诊断与统计手册》第五版AN诊断标准且接受双能X线吸收法扫描的受试者的电子病历。根据双能X线吸收法扫描结果，使用美国国家健康与营养检查调查参考数据，将LM和FM结果转换为年龄、身高、性别和种族特异性的年龄Z评分。
共有16名患AN的男孩和119名患AN的女孩符合入选标准。在未调整模型中，患AN女孩的FM Z评分（-3.24±1.50）显著低于患AN男孩的FM Z评分（-2.41±0.96）（p = 0.007）。患AN的女孩和男孩的LM均减少，但LM Z评分无显著性别差异。在多变量模型中，较低的中位数体重指数百分比与较低的FM Z评分（β = 0.08，p < 0.0001）和较低的LM Z评分（β = 0.03，p = 0.0002）显著相关，而较低的全身骨矿物质含量Z评分与较低的LM Z评分显著相关（β = 0.21，p = 0.0006）。
在未调整模型中，患AN女孩的FM缺陷显著大于患AN男孩；然而，营养不良程度似乎是造成这种差异的主要因素。在调整模型中，FM或LM无显著性别差异。
