Jornod P, Rüedi B
Département de médecine interne CHUV, Lausanne.
Rev Med Suisse Romande. 1997 Jun;117(6):485-94.
The bone density in the spine and femoral neck was measured by dual-energy X-ray absorptiometry in 24 female with anorexia nervosa 14 to 34 y.o. (20.6 +/- 5.5 y.o.). Osteopenia or osteoporosis were always present. All the cases presented with hypogonadotrophic hypogonadism and secondary amenorrhea between 4 and 194 months (40.6 +/- 53.8 months) and with low levels of oestradiol and gonadotrophins. The anorectic patient cumulates hypogonadism and a low intake of calories, calcium and vitamin D, which causes a low body mass index. These factors are more important when present before peak bone mass is reached. The gonadotrophic deficit in the young anorectic male is less obvious clinically than in the young female with amenorrhea but can be however documented with hormonal data. The osteopenia of the anorectic girl can be at least partially corrected with the hormonal and nutritional treatment. In order to reach an adequate peak bone mass in late adolescence or early adulthood and to prevent the development of osteopenia, the male and female anorectic patients should receive a hormonal substitution and an adequate nutritional supply of calcium and vitamin D, as soon as the diagnosis has been made.
采用双能X线吸收法对24例年龄在14至34岁（平均20.6±5.5岁）的神经性厌食女性患者的脊柱和股骨颈骨密度进行了测量。骨量减少或骨质疏松总是存在。所有病例均表现为低促性腺激素性性腺功能减退，继发性闭经时间在4至194个月之间（平均40.6±53.8个月），雌二醇和促性腺激素水平较低。神经性厌食患者存在性腺功能减退以及热量、钙和维生素D摄入不足的情况，这导致了低体重指数。在达到骨峰值之前出现这些因素时更为重要。年轻神经性厌食男性的促性腺激素缺乏在临床上不如闭经的年轻女性明显，但激素数据可以证明其存在。神经性厌食女孩的骨量减少至少可以通过激素和营养治疗得到部分纠正。为了在青春期后期或成年早期达到足够的骨峰值并预防骨量减少的发生，一旦确诊，男性和女性神经性厌食患者都应接受激素替代治疗，并给予充足的钙和维生素D营养供应。
