Eating disorders in adolescence: what is the role of hormone replacement therapy?
Eating disorders in adolescence: what is the role of hormone replacement therapy?
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DOI：
10.1097/gco.0b013e3282eee384
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发表时间：
2007-10-01
影响因子：
2.1
通讯作者：
Golden, Neville H.
中科院分区：
文献类型：
--
作者：
Golden, Neville H.
回顾青少年饮食失调的诊断标准和临床表现，概述治疗方法，并检查处方激素替代疗法增加神经性厌食症骨密度的证据。最近发现座位紊乱在青少年中很普遍，并可表现为闭经和月经紊乱。骨密度降低导致骨质疏松和骨折风险增加是神经性厌食症常见、严重和潜在不可逆的并发症。骨密度降低的程度取决于闭经的持续时间和营养不良的程度，有限的证据支持使用激素替代疗法来增加青少年神经性厌食症的骨密度。对于有闭经或月经紊乱的青少年，妇科医生应考虑饮食失调的可能性。可根据病史和体格检查作出诊断。如果怀疑有进食障碍，患者应接受评估和治疗。支持使用激素替代疗法来增加青少年神经性厌食症的骨密度是有限的，应该不鼓励常规使用。恢复体重、补充钙和维生素D以及恢复自然月经是主要的治疗方法。
Purpose of reviewTo review the diagnostic criteria and clinical presentation of eating disorders in adolescence, to outline an approach to treatment, and examine evidence for prescribing hormone replacement therapy to increase bone mineral density in anorexia nervosa.Recent findingsEating disorders are prevalent in adolescents and can present with amenorrhea and menstrual disturbances. Reduced bone mineral density leading to osteoporosis and increased fracture risk is a frequent, severe, and potentially irreversible complication of anorexia nervosa. The degree of bone mineral density reduction depends on the duration of amenorrhea and degree of malnutrition, Limited evidence supports the use of hormone replacement therapy to increase bone mineral density in adolescents with anorexia nervosa.SummaryIn adolescents with amenorrhea or menstrual disturbances, the gynecologist should consider the possibility of an eating disorder. The diagnosis can be made on history and physical examination. If an eating disorder is suspected, the patient should be referred for evaluation and treatment. Support for the use of hormone replacement therapy to increase bone mineral density in adolescents with anorexia nervosa is limited, and its routine use should be discouraged. Weight restoration, calcium and vitamin D supplementation and the resumption of spontaneous menses is the mainstay of treatment.