THE EFFECTS OF ESTROGEN ADMINISTRATION ON TRABECULAR BONE LOSS IN YOUNG-WOMEN WITH ANOREXIA-NERVOSA
THE EFFECTS OF ESTROGEN ADMINISTRATION ON TRABECULAR BONE LOSS IN YOUNG-WOMEN WITH ANOREXIA-NERVOSA
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DOI：
10.1210/jc.80.3.898
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发表时间：
1995-03-01
影响因子：
5.8
通讯作者：
SAXE, VC
中科院分区：
文献类型：
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作者：
KLIBANSKI, A;BILLER, BMK;SAXE, VC
为了研究长期神经性厌食症对骨密度（BD）的影响，并确定雌激素治疗是否可以预防患有这种疾病的女性的骨丢失，48名患有神经性厌食症的闭经女性（平均年龄23.7岁）被随机分为两组，22名接受雌激素和孕酮替代治疗，26名不接受替代治疗。每6个月测量一次临床变量、生化指标和脊柱骨小梁BD，平均1.5年。48名妇女中有21名的初始平均BD（130 +/- 27 mg K2 HPO 4/cm（3），+/- 1 50）显著（P < 0.001）低于正常值（176 +/- 26 mg K2 HPO 4/cm（3）），低于正常值2 SD。44名女性完成了这项研究（雌激素组19名，对照组25名）。雌激素治疗组的平均随访时间（1.57 ± 0.89年）与对照组相当。对照组（1.41 ± 0.69岁）。与对照组相比，雌激素治疗组的BD没有显著变化;然而，在初始理想体重小于70%的患者中，雌激素治疗组的平均BD增加了4.0%。相比之下，对照组患者的初始体重较低，BD下降了20.1%。对照组中月经自然恢复的妇女，她们的初始理想体重百分比都大于70%，骨量增加了19.3%。结论是：1）雌激素替代不能预防患有神经性厌食症的年轻女性的进行性骨质减少; 2）根据初始体重，一部分患者可能通过雌激素和维生素B1的给药改善BD; 3）神经性厌食症的恢复与BD的显著改善相关。
To study the effects of prolonged anorexia nervosa on bone density (BD) and to determine whether estrogen administration prevents bone loss in women with this disorder, 48 amenorrheic women with anorexia nervosa (mean age, 23.7 yr) were randomized to receive estrogen and progestin replacement (n = 22) or no replacement (n = 26). Clinical variables, biochemical indices, and spinal trabecular BD were measured every 6 months for a mean of 1.5 yr. Initial mean BD (130 +/- 27 mg K2HPO4/cm(3), +/- 1 so) was significantly (P < 0.001) less than normal (176 +/- 26 mg K2HPO4/cm(3)) and less than 2 SD below normal in 21 of the 48 women. Forty-four women completed the study (19 in the estrogen group and 25 in the control group). The mean duration of follow-up was comparable in the estrogen-treated (1.57 +/- 0.89 yr) us. the control group (1.41 +/- 0.69 yr). The estrogen-treated group had no significant change in BD compared with the control group; however, there was a 4.0% increase in mean BD in patients with an initial ideal body weight of less than 70% who were treated with estrogen. In contrast, control patients with comparably low initial weight had a 20.1% decrease in BD. Women in the control group with spontaneous resumption of menses, all of whom had an initial percent ideal body weight of greater than 70%, had a 19.3% increase in bone mass. It is concluded that: 1) estrogen replacement cannot prevent progressive osteopenia in young women with anorexia nervosa; 2) a subset of patients may have improved BD with estrogen and progestin administration depending on initial body weight; and 3) recovery from anorexia nervosa is associated with significantly improved BD.