Maïmoun Laurent, Mariano-Goulart Denis, Huguet Helena, Renard Eric, Lefebvre Patrick, Picot Marie-Christine, Dupuy Anne-Marie, Cristol Jean-Paul, Courtet Philippe, Boudousq Vincent, Avignon Antoine, Guillaume Sébastien, Sultan Ariane
Département de Médecine Nucléaire, Hôpital Lapeyronie, Centre Hospitalier Régional Universitaire (CHU) Montpellier, Montpellier, France.
PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France.
Endocr Connect. 2022 May 10;11(5):e210488. doi: 10.1530/EC-21-0488.
The two-fold aim of this study was: (i) to determine the effects of undernutrition on the myokines in patients with restrictive anorexia nervosa (AN) and (ii) to examine the potential link between myokines and bone parameters.
In this study, 42 young women with restrictive AN and 42 age-matched controls (CON) (mean age, 18.5 ± 4.2 years and 18.6 ± 4.2 years, respectively) were enrolled. aBMD and body composition were determined with DXA. Resting energy expenditure (REEm), a marker of energy status, was indirectly assessed by calorimetry. Bone turnover markers and myokines (follistatin, myostatin and irisin) were concomitantly evaluated.
AN patients presented low aBMD at all bone sites. REEm, bone formation markers, myostatin and IGF-1 were significantly lower, whereas the bone resorption marker and follistatin were higher in AN compared with controls. No difference was observed between groups for irisin levels. When the whole population was studied, among myokines, only myostatin was positively correlated with aBMD at all bone sites. However, multiple regression analyses showed that in the AN group, the independent variables for aBMD were principally amenorrhoea duration, lean tissue mass (LTM) and procollagen type I N-terminal propeptide (PINP). For CON, the independent variables for aBMD were principally LTM, age and PINP. Whatever the group analysed, none of the myokines appeared as explicative independent variables of aBMD.
This study demonstrated that despite the altered myokine levels in patients with AN, their direct effect on aBMD loss and bone turnover alteration seems limited in comparison with other well-known disease-related factors such as oestrogen deprivation.
本研究的双重目的是：（i）确定营养不良对限制性神经性厌食症（AN）患者肌动蛋白的影响，以及（ii）研究肌动蛋白与骨参数之间的潜在联系。
本研究纳入了42名患有限制性AN的年轻女性和42名年龄匹配的对照组（CON）（平均年龄分别为18.5±4.2岁和18.6±4.2岁）。采用双能X线吸收法（DXA）测定骨密度（aBMD）和身体成分。通过量热法间接评估能量状态标志物静息能量消耗（REE m）。同时评估骨转换标志物和肌动蛋白（卵泡抑素、肌肉生长抑制素和鸢尾素）。
AN患者所有骨部位的aBMD均较低。与对照组相比，AN患者的REE m、骨形成标志物、肌肉生长抑制素和胰岛素样生长因子-1显著降低，而骨吸收标志物和卵泡抑素则较高。两组间鸢尾素水平无差异。在对整个人群进行研究时，在肌动蛋白中，只有肌肉生长抑制素与所有骨部位的aBMD呈正相关。然而，多元回归分析表明，在AN组中，aBMD的独立变量主要是闭经持续时间、瘦组织质量（LTM）和I型前胶原N端前肽（PINP）。对于CON组，aBMD的独立变量主要是LTM、年龄和PINP。无论分析哪个组，肌动蛋白均未表现为aBMD的解释性独立变量。
本研究表明，尽管AN患者的肌动蛋白水平发生了改变，但与其他众所周知的疾病相关因素（如雌激素缺乏）相比，它们对aBMD丢失和骨转换改变的直接影响似乎有限。
