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青春期少经和继发性闭经女孩的骨密度降低(骨质减少)

[Lower bone density (osteopenia) in adolescent girls with oligomenorrhea and secondary amenorrhea].

作者信息

Csermely T, Halvax L, Schmidt E, Zámbó K, Péterfai J, Vadon G, Szabó I

机构信息

Pécsi Orvostudományi Egyetem, Szülészeti és Nögyógyászati Klinika.

出版信息

Orv Hetil. 1997 Oct 26;138(43):2735-41.

PMID:9411343
Abstract

Occurrence of reduced BMD among adolescent girls and young women due to certain specific oligomenorrhea or amenorrhea (anorexia nervosa, excessive sport or ballet, etc.) is well known. However the prevalence of osteopenia among 16-18 years old girls with the cycle disorders mentioned above--caused by "pure" hypothalamo-pituitary-ovarian insufficiency--is not yet sufficiently examined. The hormonal (FSH, LH, prolactin, LH/FSH, estradiol. testosterone, progesterone) and ion (Ca++,PO4(3-),Na+,K+,Cl-) parameters and the bone mineral density (BMD) of the lumbar spine of 19 girls age 16-18 with oligomenorrhea or secondary amenorrhea, due to hypothalamo-pituitary-ovarian axis insufficiency were investigated, and correlation were searched for among them. In 3 of the case significant BMD reduction was found with a value lower than the -2 SD. compared to the age, sex and race matched control values, showing definite osteoporosis. The BMD of 10 girls was between the -2.SD. and -1 SD.: they had osteopenia. Only 6 of them had normal BMD ranging from the -1 SD. to the +1 SD. Neither the ion or hormonal values, nor the clinical parameters (height, weight age, age at menarche, duration of amenorrheic period) showed correlation with the BMD values, except of the body mass index (BMI), which showed a loose positive linear correlation. The measured low BMD values have a significance, referring to a possible reduction in the peak BMD. Patients having low peak BMD have an inclination for earlier, and more sever osteoporosis and fractures in the climacteric decades. These results emphasize the need of effective and early treatment of adolescent bleeding disorders from the point of view of prevention of osteoporosis as well.

摘要

少女和年轻女性因某些特定的月经过少或闭经(神经性厌食、过度运动或芭蕾舞等)导致骨密度降低的情况已广为人知。然而,对于上述由“单纯”下丘脑 - 垂体 - 卵巢功能不全引起的周期紊乱的16 - 18岁女孩中骨质减少的患病率,尚未进行充分研究。对19名年龄在16 - 18岁、因下丘脑 - 垂体 - 卵巢轴功能不全而出现月经过少或继发性闭经的女孩的激素(促卵泡生成素、促黄体生成素、催乳素、促黄体生成素/促卵泡生成素、雌二醇、睾酮、孕酮)和离子(钙离子、磷酸根离子、钠离子、钾离子、氯离子)参数以及腰椎骨密度进行了研究,并探寻它们之间的相关性。在3例病例中发现骨密度显著降低,数值低于 -2标准差,与年龄、性别和种族匹配的对照值相比,显示出明确的骨质疏松。10名女孩的骨密度在 -2标准差和 -1标准差之间,她们患有骨质减少。只有6人的骨密度正常,范围在 -1标准差至 +1标准差之间。除了体重指数(BMI)呈现松散的正线性相关外,离子或激素值以及临床参数(身高、体重、年龄、初潮年龄、闭经持续时间)均与骨密度值无相关性。所测得的低骨密度值具有重要意义,提示峰值骨密度可能降低。峰值骨密度低的患者在更年期更容易更早且更严重地发生骨质疏松和骨折。这些结果强调,从预防骨质疏松的角度来看,也需要对青少年出血性疾病进行有效且早期的治疗。

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