Department of Internal Medicine, University of Iowa, Iowa City, IA, USA.
Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Calcif Tissue Int. 2022 May;110(5):562-575. doi: 10.1007/s00223-021-00826-3. Epub 2021 Mar 5.
Patients with anorexia nervosa (AN) often experience low bone mineral density (BMD) and increased fracture risk, with low body weight and decreased gonadal function being the strongest predictors of the observed bone mineral deficit and fractures. Other metabolic disturbances have also been linked to bone loss in this group of patients, including growth hormone resistance, low insulin-like growth factor-1 (IGF-1) concentrations, low leptin concentrations, and hypercortisolemia. However, these correlations lack definitive evidence of causality. Weight restoration and resumption of menstrual function have the strongest impact on increasing BMD. Other potential treatment options include bisphosphonates and teriparatide, supported by data from small clinical trials, but these agents are not approved for the treatment of low BMD in adolescents or premenopausal women with AN.
神经性厌食症（AN）患者常出现骨密度降低（BMD）和骨折风险增加，体重低和性腺功能减退是观察到的骨矿物质缺乏和骨折的最强预测因素。该组患者的其他代谢紊乱也与骨丢失有关，包括生长激素抵抗、胰岛素样生长因子-1（IGF-1）浓度低、瘦素浓度低和皮质醇水平升高。然而，这些相关性缺乏因果关系的确凿证据。体重恢复和月经功能恢复对增加 BMD 的影响最大。其他潜在的治疗选择包括双膦酸盐和特立帕肽，这些药物的数据来自小型临床试验，但这些药物未被批准用于治疗青少年或 AN 绝经前妇女的低 BMD。
