Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Bone. 2019 Jan;118:47-52. doi: 10.1016/j.bone.2018.02.013. Epub 2018 Feb 16.
Anorexia nervosa (AN) is a psychiatric disorder characterized by inappropriate nutrient intake resulting in low body weight. Multiple hormonal adaptations facilitate decreased energy expenditure in this state of caloric deprivation including non-thyroidal illness syndrome, growth hormone resistance, and hypogonadotropic hypogonadism. Although these hormonal adaptations confer a survival advantage during periods of negative energy balance, they contribute to the long-term medical complications associated with AN, the most common of which is significant bone loss and an increased risk of fracture. In recent years, marrow adipose tissue (MAT) has emerged as an important potential determinant of the low bone mass state characteristic of AN. Unlike subcutaneous and visceral adipose tissue depots which are low in AN, MAT levels are paradoxically elevated and are inversely associated with BMD. In this review, we discuss what is known about MAT in AN and the proposed hormonal determinants of this adipose tissue depot.
神经性厌食症（AN）是一种精神疾病，其特征是不适当的营养摄入导致体重过低。在这种热量缺乏的状态下，多种激素适应有助于降低能量消耗，包括非甲状腺疾病综合征、生长激素抵抗和促性腺激素低下性性腺功能减退症。尽管这些激素适应在负氮平衡期间提供了生存优势，但它们导致了与 AN 相关的长期医学并发症，其中最常见的是显著的骨丢失和骨折风险增加。近年来，骨髓脂肪组织（MAT）已成为 AN 特征性低骨量状态的一个重要潜在决定因素。与 AN 中皮下和内脏脂肪组织储存量低不同，MAT 水平异常升高，并且与 BMD 呈负相关。在这篇综述中，我们讨论了关于 AN 中 MAT 的已知内容以及该脂肪组织储存的拟议激素决定因素。
