Division of Internal Medicine, Department of Medicine, Surgery and Neuroscience, University of Siena, Policlinico Le Scotte, Viale Bracci 2, 53100, Siena, Italy.
Division of Psychiatry, Department of Molecular Medicine, University of Siena, Siena, Italy.
Eat Weight Disord. 2022 Dec;27(8):3207-3213. doi: 10.1007/s40519-022-01450-2. Epub 2022 Jul 28.
Reduced bone mineral density (BMD) and increase risk of fragility fracture are common complication of anorexia nervosa (AN). BMD by dual-energy X-ray absorptiometry (DXA) present several limits in subjects with AN. This study aimed to evaluate the usefulness of the new Radiofrequency echographic multispectrometry (REMS) technique in the assessment of bone status in young women with AN.
In a cohort of 50 subjects with restrictive AN and in 30 healthy controls, we measured BMD at the lumbar spine (LS-BMD), at femoral neck (FN-BMD) and total hip (TH-BMD) using both DXA and REMS technique.
BMD evaluated by DXA and REMS technique at all measurement sites were all significantly (p < 0.01) lower in subjects suffering from AN subjects than in controls. Good correlations were detected between BMD by DXA and BMD by REMS measurements at LS (r = 0.64, p < 0.01) at FN (r = 0.86, p < 0.01) and at TH (r = 0.84, p < 0.01) in subjects suffering from AN. Moreover, Bland-Altman analysis confirmed the good agreement between the two techniques. The subjects suffering from AN with previous vertebral fragility fractures presented lower values of both BMD-LS and BMD-TH by DXA and by REMS with respect to those without fractures; however, the difference was significant only for BMD-TH by REMS (p < 0.05).
Our data suggest that REMS technique due to its characteristic of precision and reproducibility may represent an important tool for the evaluation of the changes in bone status in AN young women, especially during the fertile age and in case of pregnancy and breastfeeding.
Level of evidence: level III cohort study.
骨密度（BMD）降低和脆性骨折风险增加是神经性厌食症（AN）的常见并发症。双能 X 射线吸收法（DXA）测量的 BMD 在患有 AN 的患者中存在一些局限性。本研究旨在评估新型射频超声多光谱（REMS）技术在评估年轻女性 AN 患者骨骼状况中的有用性。
在一组 50 名患有限制性 AN 的患者和 30 名健康对照者中，我们使用 DXA 和 REMS 技术分别测量腰椎（LS-BMD）、股骨颈（FN-BMD）和全髋（TH-BMD）的 BMD。
与对照组相比，所有 DXA 和 REMS 技术测量部位的 BMD 在患有 AN 的患者中均显著降低（p<0.01）。在患有 AN 的患者中，DXA 和 REMS 测量的 LS（r=0.64，p<0.01）、FN（r=0.86，p<0.01）和 TH（r=0.84，p<0.01）的 BMD 之间均检测到良好的相关性。此外，Bland-Altman 分析证实了两种技术之间的良好一致性。与无骨折者相比，有过椎体脆性骨折的 AN 患者 DXA 和 REMS 测量的 LS-BMD 和 TH-BMD 均较低，但仅在 REMS 测量的 TH-BMD 中差异具有统计学意义（p<0.05）。
我们的数据表明，REMS 技术由于其精确性和可重复性的特点，可能是评估年轻女性 AN 患者骨骼状况变化的重要工具，特别是在生育年龄以及怀孕和哺乳期。
证据等级：III 级队列研究。
Zotero 插件
