Maimoun Laurent, Huguet Helena, Renard Eric, Lefebvre Patrick, Seneque Maude, Gaspari Laura, Boudousq Vincent, Maimoun Nande Lisa, Courtet Philippe, Sultan Charles, Mariano-Goulart Denis, Picot Marie-Christine, Guillaume Sebastien
Physiology and Experimental Medicine of the Heart and Muscles (PhyMedExp), CNRS, INSERM, University of Montpellier, 34295 Montpellier, France.
Department of Nuclear Medicine, CHU Montpellier, 34295 Montpellier, France.
Nutrients. 2024 Dec 31;17(1):161. doi: 10.3390/nu17010161.
Developing a scoring assessment tools for the determination of low bone mass for age at lumbar spine and hip in patients with anorexia nervosa (AN).
The areal bone mineral density (aBMD) was determined with dual-energy X-ray absorptiometry (DXA). In 331 women with AN and 121 controls, aged from 14.5 to 34.9 years, univariate and multivariate logistic regression analyses were performed to address the association of Z-score aBMD evaluated at lumbar spine and hip with several parameters.
For the lumbar spine and hip, the three risk factors significantly and independently associated with Z-score aBMD were age of patients (variable in class ≥20 year vs. <20 year), minimal disease-related BMI (continuous variable), and duration of amenorrhea without contraceptive use (variable in class ≥18 months vs. <18 months), with close values for the odds ratio for the two bone sites. A simple risk score equation was developed and tested combining only these three parameters. The AUC's measuring the score's performance were, respectively, 0.85 [95% CI: 0.79-0.90] with a sensitivity of 83% and specificity of 71%, and 0.82 [95% CI: 0.76-0.86] with a sensitivity of 92% and specificity of 55% to detect low aBMD in lumbar spine and hip. The cut-off values for low bone mass for age were 0.9 and 1.33 for the two bone sites. The prediction model revealed that a minimum of 83% of the patients presenting low bone mass for age were correctly identified.
the study presents for the first time a risk score for diagnosing low bone mass for age in young patients with AN. Considering its excellent sensitivity, and its ease of use, requiring only three parameters that are well identified in this disease, this new score may be useful in clinical settings when DXA scans are not feasible.
开发一种评分评估工具，用于确定神经性厌食症（AN）患者腰椎和髋部的年龄相关低骨量。
采用双能X线吸收法（DXA）测定面积骨密度（aBMD）。对331例年龄在14.5至34.9岁的AN女性患者和121例对照者进行单因素和多因素逻辑回归分析，以探讨腰椎和髋部Z评分aBMD与多个参数之间的关联。
对于腰椎和髋部，与Z评分aBMD显著且独立相关的三个危险因素是患者年龄（分类变量≥20岁与<20岁）、最低疾病相关体重指数（连续变量）以及无避孕措施的闭经持续时间（分类变量≥18个月与<18个月），两个骨部位的比值比数值相近。仅结合这三个参数开发并测试了一个简单的风险评分方程。用于测量该评分性能的AUC分别为0.85 [95%CI：0.79 - 0.90]，敏感性为83%，特异性为71%，以及0.82 [95%CI：0.76 - 0.86]，敏感性为92%，特异性为55%，用于检测腰椎和髋部的低aBMD。两个骨部位年龄相关低骨量的截断值分别为0.9和1.33。预测模型显示，至少83%的年龄相关低骨量患者被正确识别。
该研究首次提出了一种用于诊断年轻AN患者年龄相关低骨量的风险评分。考虑到其出色的敏感性以及易用性，仅需该疾病中明确的三个参数，当DXA扫描不可行时，这个新评分在临床环境中可能会有用。
