Wasserman Halley M, Kalkwarf Heidi J, Altaye Mekibib, Yolton Kimberly, Kanj Rula V, Gordon Catherine M
Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, Ohio.
J Pediatr Adolesc Gynecol. 2023 Apr;36(2):122-127. doi: 10.1016/j.jpag.2022.10.003. Epub 2022 Oct 7.
To characterize the skeletal, cardiometabolic, cognitive, and mental health phenotype of adolescents with idiopathic premature ovarian insufficiency (POI) DESIGN: Case control SETTING: Pediatric tertiary referral center in Cincinnati, Ohio PARTICIPANTS: Nine adolescents (ages 11-18.99 years) with newly diagnosed POI and 9 normally menstruating controls, matched by age and body mass index MAIN OUTCOME MEASURES: Between-group comparisons of bone characteristics assessed by dual energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), psychosocial health (anxiety, depression, and quality of life), and cognition and memory by questionnaire RESULTS: Adolescents with POI had lower bone density Z-scores by DXA (lumbar spine -1.93 vs 0.80; whole body less head -2.05 vs 0.00; total hip -1.03 vs 0.83; and femoral neck -1.23 vs 0.91; all P < .001), as well as lower trabecular volumetric bone mineral density (tibia 3% site 226 vs 288 mg/mm, P < .001; radius 3% site 200 vs 251, P = .001), smaller cortical area (tibia 66% site 251 vs 292 mm, P = .028), and thickness (tibia 66% site 3.56 vs 4.30 mm, P = .001) than controls. No abnormalities in cardiometabolic biomarkers were detected in POI cases. Adolescents with POI were also more likely to report low energy (78% vs 22%, P = .02).
Estrogen deficiency adversely affects bone health in adolescents with POI. However, we did not find associations with cardiometabolic, mental health, or cognitive outcomes in this small sample.
描述特发性卵巢早衰（POI）青少年的骨骼、心脏代谢、认知和心理健康表型
病例对照研究
俄亥俄州辛辛那提市的儿科三级转诊中心
9名新诊断为POI的青少年（年龄11 - 18.99岁）和9名月经正常的对照者，根据年龄和体重指数进行匹配
通过双能X线吸收法（DXA）和外周定量计算机断层扫描（pQCT）评估的骨特征、心理社会健康（焦虑、抑郁和生活质量）以及通过问卷调查评估的认知和记忆的组间比较
POI青少年的DXA骨密度Z值较低（腰椎-1.93 vs 0.80；全身除头部-2.05 vs 0.00；全髋-1.03 vs 0.83；股骨颈-1.23 vs 0.91；所有P <.001），以及较低的小梁体积骨密度（胫骨3%部位226 vs 288 mg/mm，P <.001；桡骨3%部位200 vs 251，P =.001），皮质面积较小（胫骨66%部位251 vs 292 mm，P =.028），厚度较薄（胫骨66%部位3.56 vs 4.30 mm，P =.001），均低于对照组。POI病例中未检测到心脏代谢生物标志物异常。POI青少年也更有可能报告精力不足（78% vs 22%，P =.02）。
雌激素缺乏对POI青少年的骨骼健康有不利影响。然而，在这个小样本中，我们未发现与心脏代谢、心理健康或认知结果之间存在关联。
