Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University Ihsan Dogramaci Children's Hospital, Ankara, Turkey.
J Bone Miner Metab. 2021 Jul;39(4):678-683. doi: 10.1007/s00774-021-01211-8. Epub 2021 Mar 12.
We aimed to evaluate the bone mineral density (BMD) z scores of adolescents with atypical anorexia nervosa (AAN) and investigate the potential predictors of low BMD risk.
Potential factors that might have an effect on the femoral neck and lumbar spine dual energy X-ray absorptiometry data of adolescents (11-18 years) with AAN were retrospectively evaluated.
Among adolescents with AAN, 13 (34.2%) had a z score lower than - 1 and 25 (65.8%) had a z score equal or greater than - 1. When adolescents with a BMD score lower and higher than - 1 were compared, normal BMD group had a significantly higher mean lifetime maximum BMI (p = 0.0035). Similarly previous overweight history was significantly higher in the normal BMD group (p = 0.005). A positive correlation was found between femoral neck (p = 0.002, r: 0.546) and lumbar spine (p: 0.002, r: 0.505) z scores and lifetime maximum BMI. There was also a positive correlation between lumbar spine BMD scores and BMI at admission (p = 0.001, r: 0.540). Lumbar spine z scores and amenorrhea duration were negatively correlated (p: 0.002, r: - 10.867).
In the adolescent period similar to AN, AAN cases are also at risk for disordered bone health. In adolescents with AAN, BMI prior to the illness was estimated to be the significant parameter for the risk of low BMD. Special attention should be paid to the bone health of adolescents with AAN, especially for those who do not have a previous overweight history.
本研究旨在评估非典型神经性厌食症（AAN）青少年的骨密度（BMD）Z 评分，并探讨低 BMD 风险的潜在预测因素。
回顾性评估了可能影响 AAN 青少年（11-18 岁）股骨颈和腰椎双能 X 射线吸收法数据的潜在因素。
在 AAN 青少年中，13 例（34.2%）的 Z 评分低于-1，25 例（65.8%）的 Z 评分等于或大于-1。比较 BMD 评分低于和高于-1 的青少年，正常 BMD 组的平均终生最大 BMI 显著较高（p=0.0035）。同样，正常 BMD 组的既往超重史也显著较高（p=0.005）。股骨颈（p=0.002，r：0.546）和腰椎（p=0.002，r：0.505）Z 评分与终生最大 BMI 呈正相关。腰椎 BMD 评分与入院时 BMI 呈正相关（p=0.001，r：0.540）。腰椎 Z 评分与闭经时间呈负相关（p=0.002，r：-10.867）。
在青少年期与 AN 相似，AAN 病例也存在骨骼健康紊乱的风险。在 AAN 青少年中，疾病前 BMI 被估计为低 BMD 风险的重要参数。应特别关注 AAN 青少年的骨骼健康，特别是对于没有既往超重史的患者。
