Does hormone replacement normalize bone geometry in adolescents with anorexia nervosa?
Does hormone replacement normalize bone geometry in adolescents with anorexia nervosa?
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DOI：
10.1002/jbmr.2005
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发表时间：
2014-01
影响因子：
6.2
通讯作者：
Gordon, Catherine M.
中科院分区：
文献类型：
--
作者：
DiVasta, Amy D.;Feldman, Henry A.;Beck, Thomas J.;LeBoff, Meryl S.;Gordon, Catherine M.
患有神经性厌食症（AN）的年轻女性的脱氢表雄酮（DHEA）和雌激素分泌减少，导致骨骼缺陷。在这项随机、安慰剂对照试验中，我们研究了口服脱氢表雄酮+复方口服避孕药（COC）与安慰剂对年轻女性AN骨几何结构变化的影响。80例年龄13 - 27岁的AN患者随机双盲接受微粒化DHEA（50 mg/d）+COC（20 μ g炔雌醇/0.1mg左炔诺孕酮）或安慰剂治疗18个月。在0、6、12和18个月时，通过双能X线骨密度仪测量全髋关节的aBMD。我们使用髋关节结构分析（HSA）程序来确定股骨颈和股骨干的BMD、横截面积（CSA）和截面模量。每个测量值表示为来自健康青少年女性的独立样本的年龄、身高和瘦体重特异性平均值的百分比。在18个月内，DHEA + COC导致股骨干BMD稳定（年龄，身高和瘦体重正常平均值的0.0 ± 0.5%/年），而安慰剂组降低（-1.1 ± 0.5%/年，p = 0.03）。同样，CSA、截面模量和皮质厚度也随着治疗而改善。在患有AN的年轻女性中，肾上腺和性腺激素替代改善了骨骼健康并增加了横截面几何形状。我们的研究结果表明，这种联合治疗对AN年轻女性的骨强度替代指标有有益的影响，而不仅仅是骨密度。
Young women with anorexia nervosa (AN) have reduced secretion of dehydroepiandrosterone (DHEA) and estrogen contributing to skeletal deficits. In this randomized, placebo-controlled trial, we investigated the effects of oral DHEA+ combined oral contraceptive (COC) vs. placebo on changes in bone geometry in young women with AN. Eighty women with AN, aged 13-27 yr, received a random, double-blinded assignment to micronized DHEA (50 mg/d) + COC (20μg ethinyl estradiol/0.1mg levonorgestrel) or placebo for 18 mo. Measurements of aBMD at the total hip were obtained by dual-energy X-ray absorptiometry at 0, 6, 12, and 18 mo. We used the Hip Structural Analysis (HSA) Program to determine BMD, cross-sectional area (CSA), and section modulus at the femoral neck and shaft. Each measurement was expressed as a percentage of the age-, height-, and lean mass-specific mean from an independent sample of healthy adolescent females. Over the 18 months, DHEA+COC led to stabilization in femoral shaft BMD (0.0 ± 0.5 % of normal mean for age, height, and lean mass/year) compared with decreases in the placebo group (−1.1 ± 0.5% per year, p=0.03). Similarly, CSA, section modulus, and cortical thickness improved with treatment. In young women with AN, adrenal and gonadal hormone replacement improved bone health and increased cross sectional geometry. Our results indicate that this combination treatment has a beneficial impact on surrogate measures of bone strength, and not only bone density, in young women with AN.
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影响因子：
5.8
作者：
KLIBANSKI, A;BILLER, BMK;SAXE, VC
通讯作者：
SAXE, VC
影响因子：
3.3
作者：
Leppanen, Olli V.;Sievanen, Harri;Jarvinen, Teppo L. N.
通讯作者：
Jarvinen, Teppo L. N.
影响因子：
4.9
作者：
TAELMAN, P;KAUFMAN, JM;VERMEULEN, A
通讯作者：
VERMEULEN, A
影响因子：
6.7
作者：
BECK, TJ;RUFF, CB;RAO, GU
通讯作者：
RAO, GU
影响因子：
4
作者：
DiVasta, A. D.;Beck, T. J.;Gordon, C. M.
通讯作者：
Gordon, C. M.