比较神经性厌食症和非典型神经性厌食症青少年的骨密度和身体成分。
Comparisons of bone density and body composition among adolescents with anorexia nervosa and atypical anorexia nervosa.
机构信息
Department of Pediatrics, University of California, San Francisco, California.
Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California.
出版信息
Int J Eat Disord. 2019 May;52(5):591-596. doi: 10.1002/eat.23048. Epub 2019 Feb 16.
OBJECTIVE
To compare bone mineral density (BMD) and body composition among adolescents: (a) with atypical anorexia nervosa (AAN) versus anorexia nervosa (AN) and (b) those with and without a prior history of overweight.
METHOD
Electronic medical records of patients 9-20 years with AN or AAN who underwent dual-energy x-ray absorptiometry scans were retrospectively reviewed and analyzed.
RESULTS
A total of 286 adolescents with AN or AAN were included. In linear regression models, AAN was associated with greater Z-scores in whole body bone mineral content (BMC, B = 0.88, p < 0.001), lumbar spine BMD (B = 0.79, p = 0.002), femoral neck BMD (B = 0.670, p = 0.009); fat mass index (B = 1.33, p = 0.003), and lean body mass index (LBMI, B = 1.10, p < 0.001) compared to AN, adjusting for age, sex, and duration of illness. A prior overweight history was associated with greater Z-scores in whole body BMC; lumbar spine BMD, total hip BMD, femoral neck BMD, and LBMI.
DISCUSSION
Adolescents with AAN had higher BMD Z-scores than adolescents with AN; adolescents with a prior overweight history had greater BMD Z-scores than adolescents without a prior overweight history. These findings may inform clinical guidelines for the medical management of AAN.
目的
比较青少年中不典型厌食症（AAN）与厌食症（AN）患者的骨密度（BMD）和身体成分，（a）比较不典型厌食症与厌食症患者，（b）比较有超重史与无超重史的患者。
方法
回顾性分析了 9-20 岁接受双能 X 线吸收法扫描的 AN 或 AAN 患者的电子病历。
结果
共纳入 286 例 AN 或 AAN 青少年。在线性回归模型中，AAN 与全身骨矿物质含量（BMC）Z 分数更高相关（B=0.88，p<0.001），腰椎 BMD（B=0.79，p=0.002），股骨颈 BMD（B=0.670，p=0.009）；脂肪量指数（B=1.33，p=0.003）和瘦体重指数（LBMI，B=1.10，p<0.001）与 AN 相比，调整了年龄、性别和疾病持续时间。超重史与全身 BMC；腰椎 BMD、总髋 BMD、股骨颈 BMD 和 LBMI 的 Z 分数更高相关。
讨论
与 AN 患者相比，AAN 青少年的 BMD Z 分数更高；有超重史的青少年的 BMD Z 分数高于无超重史的青少年。这些发现可能为 AAN 的医疗管理指南提供信息。
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