Thavaraputta Subhanudh, Fazeli Pouneh K
Neuroendocrinology Unit, Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
J Psychiatr Brain Sci. 2022;7(3). doi: 10.20900/jpbs.20220004. Epub 2022 Jul 4.
Anorexia nervosa is a disorder of chronic, self-induced negative energy balance which typically results in a low body weight. Functional hypothalamic amenorrhea is an adaptive response to states of negative energy balance and chronic undernutrition. A majority of women with anorexia nervosa are amenorrheic with resultant hypoestrogenemia, and longer durations of amenorrhea are associated with lower bone mineral density in this population. In this review, we highlight studies that have investigated the effects of estrogen replacement on bone mineral density in anorexia nervosa, including prospective and randomized studies that show no benefit to treatment with oral estrogen with respect to bone mineral density in either adolescent girls or women with anorexia nervosa. We also review data from a randomized, placebo-controlled study in adolescent girls and a prospective, open-label pilot study in women with anorexia nervosa suggesting that transdermal estrogen may have beneficial effects with respect to bone mineral density in this population.
神经性厌食症是一种慢性的、自我诱发的负能量平衡紊乱疾病，通常会导致体重过低。功能性下丘脑性闭经是对负能量平衡和慢性营养不良状态的一种适应性反应。大多数神经性厌食症女性会闭经，从而导致雌激素水平过低，在这一人群中，闭经时间越长，骨密度越低。在本综述中，我们重点介绍了一些研究，这些研究调查了雌激素替代疗法对神经性厌食症患者骨密度的影响，包括前瞻性和随机研究，这些研究表明，对于青少年女孩或神经性厌食症女性，口服雌激素治疗对骨密度没有益处。我们还回顾了一项针对青少年女孩的随机、安慰剂对照研究以及一项针对神经性厌食症女性的前瞻性、开放标签试点研究的数据，这些数据表明，经皮雌激素可能对这一人群的骨密度有有益影响。
