Pehlivantürk Kızılkan Melis, Akgül Sinem, Derman Orhan, Kanbur Nuray
Hacettepe University Ihsan Dogramaci Children's Hospital, Department of Pediatrics, Division of Adolescent Medicine, Ankara, Turkey.
J Pediatr Endocrinol Metab. 2018 Apr 25;31(5):545-550. doi: 10.1515/jpem-2017-0342.
The negative impact of anorexia nervosa (AN) on bone health is well defined. However, there are very few studies evaluating the effect of constitutional thinness on bone health, especially in the adolescent period and in the male gender. The aim of this study is to compare the bone mineral density (BMD) measurements of adolescents with AN and with constitutional thinness.
Between April 2013 and March 2014, 40 adolescents with AN and 36 adolescents with constitutional thinness participated in the study. The femoral neck and lumbar spine BMD were measured by dual energy X-ray absorptiometry (DXA).
Mean lumbar z and BMD scores of adolescents with constitutional thinness were significantly lower than in adolescents with AN, whereas the mean femoral z and BMD scores were not significantly different. When males were compared separately, lumbar z and BMD values of the constitutionally thin group were found to be significantly lower than in the AN group. This difference was not significant for females.
The difference between the male and female results of our study suggested two hypotheses. The significantly lower BMD values in constitutionally thin boys are attributed to their longer duration of low body mass index (BMI). Although the duration of low BMI is also longer for constitutionally thin girls, similar BMD values of AN and constitutionally thin female groups are attributed to the additional negative impact of estrogen deficiency on the bone health of girls with AN.
神经性厌食症（AN）对骨骼健康的负面影响已得到明确界定。然而，评估体质性消瘦对骨骼健康影响的研究非常少，尤其是在青春期和男性群体中。本研究的目的是比较患有AN的青少年和体质性消瘦青少年的骨密度（BMD）测量值。
2013年4月至2014年3月期间，40名患有AN的青少年和36名体质性消瘦的青少年参与了本研究。采用双能X线吸收法（DXA）测量股骨颈和腰椎的骨密度。
体质性消瘦青少年的腰椎z值和骨密度评分均值显著低于患有AN的青少年，而股骨z值和骨密度评分均值无显著差异。当分别比较男性时，发现体质性消瘦组的腰椎z值和骨密度值显著低于AN组。女性之间的这种差异不显著。
我们研究中男性和女性结果的差异提出了两个假设。体质性消瘦男孩的骨密度值显著较低归因于他们低体重指数（BMI）持续时间较长。虽然体质性消瘦女孩的低BMI持续时间也较长，但AN组和体质性消瘦女性组相似的骨密度值归因于雌激素缺乏对患有AN的女孩骨骼健康的额外负面影响。
