Department of Medicine and Optometry, Linnaeus University, SE, 391 82, Kalmar, Sweden.
Department of Medical and Health Sciences, University of Linköping, SE, 581 83, Linköping, Sweden.
Eat Weight Disord. 2021 Oct;26(7):2165-2172. doi: 10.1007/s40519-020-01062-8. Epub 2020 Nov 6.
Adult women with long-time anorexia nervosa (AN) are believed to have osteopenia (T-score ≤ 1.0) in 93 % and osteoporosis (T-score ≤ 2.5) in 38 %. Bone microarchitecture assessed by Trabecular Bone Score (TBS) predicts osteoporotic fractures. Our aim was to evaluate the microarchitecture in adult females with AN by determining TBS and to identify factors potentially associated with TBS, such as bone turnover markers.
20 female patients with AN (DSM IV), aged 27.8 ± 4.4 years, BMI 16.6 ± 0.6 kg/m and duration of illness of 8.5 ± 5 years had previously been evaluated with dual-energy X-ray absorptiometry (DXA). TBS measurements were now obtained, using iNsight software, from spinal DXA images. Serum levels of bone turnover markers were determined in patients and healthy normal-weight controls.
Compared to controls serum values of osteopontin were higher (p = 0.009). BMD in patients with AN was reduced by at least 1.0 SD at one or more skeletal sites in 65 % of patients and by at least 2.5 SD in 20 %. Only one of the patients (5%) had suffered a fracture. TBS (mean 1.35 ± 0.06; median 1.36 (1.23-1.44) was in the lower normal range (≥ 1.35). 40 % of patients showed partially (> 1.20 and < 1.35) but none showed a fully degraded micro-architecture.
In Swedish AN patients we found a low reduction of BMD and fracture history. The bone microarchitecture, evaluated for the first time for this group by TBS, was only modestly compromised, and to a lesser extent than expected for this group of patients with AN.
Level V; cross-sectional descriptive study.
据信，患有长期神经性厌食症（AN）的成年女性中有 93%存在骨量减少（T 评分≤1.0），38%存在骨质疏松症（T 评分≤2.5）。通过骨小梁评分（TBS）评估的骨微结构可预测骨质疏松性骨折。我们的目的是通过测定 TBS 来评估患有 AN 的成年女性的微结构，并确定与 TBS 相关的潜在因素，如骨转换标志物。
20 名患有 AN（DSM-IV）的女性患者，年龄 27.8±4.4 岁，BMI 16.6±0.6 kg/m2，患病时间 8.5±5 年，此前曾接受过双能 X 射线吸收法（DXA）评估。现在使用 iNsight 软件从脊柱 DXA 图像中获取 TBS 测量值。测定患者和健康体重正常对照者的血清骨转换标志物水平。
与对照组相比，血清骨桥蛋白值较高（p=0.009）。在 65%的患者中，至少有一个或多个骨骼部位的 AN 患者的 BMD 减少至少 1.0 SD，在 20%的患者中减少至少 2.5 SD。只有 1 名患者（5%）发生过骨折。TBS（平均值 1.35±0.06；中位数 1.36（1.23-1.44）在正常低值范围内（≥1.35）。40%的患者表现出部分（>1.20 和<1.35）但没有完全降低的微结构。
在瑞典的 AN 患者中，我们发现 BMD 减少和骨折病史较少。骨微结构，这是首次针对该组患者通过 TBS 进行评估，仅略有受损，而且比该组 AN 患者预期的受损程度要小。
V 级；横断面描述性研究。
