de Araújo Iana Mizumukai, Rebolho Maria Victoria Figueiredo, Gomes Mayra Macena, Suen Vivian Marques, de Paula Francisco José Albuquerque
Department of Internal Medicine, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
Eating Disorder Support Group, Hospital das Clinicas, Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
Endocrine. 2025 Apr 18. doi: 10.1007/s12020-025-04231-w.
Anorexia nervosa is a psychiatric disorder characterized by self-imposed fasting and significant weight loss, leading to nutrient deficiencies that disrupt bone metabolism. This cross-sectional observational study aimed to characterize the bone health of women with anorexia nervosa using dual-energy X-ray absorptiometry (DXA), trabecular bone score (TBS), and 3D shaper analysis.
The study involved 12 women diagnosed with anorexia nervosa monitored by a multidisciplinary team and 11 control subjects. Both groups underwent blood sampling and assessments with DXA, TBS, and 3D shaper analysis.
The results indicated that areal bone mineral density (aBMD) and Z-scores at the total hip and femoral neck were significantly lower in the anorexia group compared to controls (p < 0.05). Additionally, the fat mass index was reduced in women with anorexia (p < 0.05). Appendicular lean mass index (ALMI) was similar between the two groups. 3D shaper analysis revealed that surface BMD (sBMD), volumetric BMD (vBMD), integral vBMD, and trabecular vBMD were generally lower in the anorexia group. Associations were found between proximal femur 3D parameters and total hip and femoral neck aBMD. Moreover, significant correlations were observed between total cortical vBMD, total cortical sBMD, integral vBMD, and TBS. ALMI was associated with total cortical thickness and showed a trend toward association with femoral neck Z-score.
In addition to previous studies indicating bone impairment in AN using DXA and TBS, the present study suggests that the 3D Shaper is also capable of detecting bone loss in this disorder. Therefore, the data encourage the further studies to assess the role of the 3D Shaper in prediction of fracture.
神经性厌食症是一种精神疾病，其特征为自我禁食和显著体重减轻，导致营养缺乏，进而扰乱骨骼代谢。这项横断面观察性研究旨在使用双能X线吸收法（DXA）、小梁骨评分（TBS）和三维形态分析来描述神经性厌食症女性的骨骼健康状况。
该研究纳入了12名由多学科团队监测的被诊断为神经性厌食症的女性以及11名对照受试者。两组均接受了血液采样以及DXA、TBS和三维形态分析评估。
结果表明，与对照组相比，神经性厌食症组的全髋和股骨颈的骨矿物质密度（aBMD）和Z值显著更低（p < 0.05）。此外，神经性厌食症女性的脂肪量指数降低（p < 0.05）。两组间的四肢瘦体重指数（ALMI）相似。三维形态分析显示，神经性厌食症组的表面骨密度（sBMD）、体积骨密度（vBMD）、积分vBMD和小梁vBMD总体上更低。发现股骨近端三维参数与全髋和股骨颈aBMD之间存在关联。此外，观察到总皮质vBMD、总皮质sBMD、积分vBMD和TBS之间存在显著相关性。ALMI与总皮质厚度相关，并显示出与股骨颈Z值相关的趋势。
除了先前使用DXA和TBS表明神经性厌食症存在骨损伤的研究外，本研究表明三维形态分析也能够检测出这种疾病中的骨质流失。因此，这些数据鼓励进一步研究以评估三维形态分析在骨折预测中的作用。
