Kooh S W, Noriega E, Leslie K, Müller C, Harrison J E
Division of Endocrinology, University of Toronto, Ontario, Canada.
Bone. 1996 Aug;19(2):181-8. doi: 10.1016/8756-3282(96)00162-7.
The relationship between bone mass and compartments of soft tissue was studied in 22 adolescent women with anorexia nervosa (mean, 17 years). Results were compared to data on age- and gender-matched controls. Bone mass of the lumbar vertebrae and femoral neck, fat and lean tissue was measured by dual energy X-ray absorptiometry (DXA). Bone mass in the central third of the skeleton, by neutron activation analysis (NAA), and body protein, by prompt gamma ray analysis (PGA), was measured on patients, but not controls. The patients had significantly lower values than controls in total weight (26%), lean tissue (16%), fat (60%), bone mass of lumbar spine (14%), and femoral neck (15%). The mean calcium bone index (CaBI), the central skeletal calcium normalized for body size based on height, was significantly lower than the value for external controls, (0.86 +/- 0.10 vs. 0.97 +/- 0.10). The nitrogen index (NI), body protein normalized for height, showed a similar reduction from external controls (0.84 +/- 0.10 vs. 1.0 +/- 0.10). Bone mass (both DXA and NAA data) was strongly correlated to lean tissue and to protein; the correlations to fat were weaker. Follow-up studies after 7-26 months in 12 patients showed a modest increase in weight (mean, 4.9 kg) which was due, primarily, to an increase in fat with only insignificant increase in lean tissue and in protein. In bone mass, there was either no change or further loss. Only four restored body weight to normal (BMI > 20) and they achieved normal menstruation, but even these four responders showed no increase in bone mass. Our studies confirm that adolescent females with anorexia nervosa suffer losses not only in all compartments of body composition, but also demonstrate that the restoration of bone mass lags behind improvement in soft tissue compartments. These results were independent of methods used for the measurements.
对22名患有神经性厌食症的青春期女性（平均年龄17岁）的骨量与软组织各部分之间的关系进行了研究。将结果与年龄和性别匹配的对照组数据进行比较。通过双能X线吸收法（DXA）测量腰椎和股骨颈的骨量、脂肪和瘦组织。对患者采用中子活化分析法（NAA）测量骨骼中部三分之一的骨量，采用瞬发γ射线分析法（PGA）测量身体蛋白质含量，但对照组未进行此项测量。患者的总体重（降低26%）、瘦组织（降低16%）、脂肪（降低60%）、腰椎骨量（降低14%）和股骨颈骨量（降低15%）均显著低于对照组。平均钙骨指数（CaBI），即根据身高对身体大小进行标准化后的骨骼中部钙含量，显著低于外部对照组的值（0.86±0.10对0.97±0.10）。氮指数（NI），即根据身高进行标准化后的身体蛋白质含量，与外部对照组相比也有类似程度的降低（0.84±0.10对1.0±0.10）。骨量（DXA和NAA数据）与瘦组织和蛋白质密切相关；与脂肪的相关性较弱。对12名患者进行7至26个月的随访研究发现，体重有适度增加（平均增加4.9千克），这主要是由于脂肪增加，而瘦组织和蛋白质仅略有增加。骨量方面，要么没有变化，要么进一步减少。只有4名患者体重恢复正常（体重指数>20）且月经恢复正常，但即使是这4名有反应的患者骨量也没有增加。我们的研究证实，患有神经性厌食症的青春期女性不仅身体成分的所有部分都有损失，而且还表明骨量的恢复落后于软组织部分的改善。这些结果与所使用的测量方法无关。
