The effect of gonadal and adrenal steroid therapy on skeletal health in adolescents and young women with anorexia nervosa.
The effect of gonadal and adrenal steroid therapy on skeletal health in adolescents and young women with anorexia nervosa.
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DOI：
10.1016/j.metabol.2011.11.016
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发表时间：
2012-07
期刊：
影响因子：
--
通讯作者：
Gordon CM
中科院分区：
文献类型：
--
作者：
Divasta AD;Feldman HA;Giancaterino C;Rosen CJ;Leboff MS;Gordon CM
神经性厌食症（AN）的特征是雌激素和脱氢表雄酮（DHEA）水平低于正常。我们试图确定DHEA +雌激素/维生素E的组合在保持AN的骨骼健康超过18个月方面是否优于安慰剂上级。招募13至27岁的AN女性参与这项双盲、安慰剂对照、随机试验。94例受试者接受随机分组，其中80例完成基线评估，并接受研究药物（口服微粒化DHEA 50 mg + 20 µg炔雌醇/0.1 mg左炔诺孕酮联合口服避孕药[COC]每日一次; n = 43）或安慰剂（n = 37）。连续测量骨密度（aBMD）、骨转换标志物和血清激素浓度。60例受试者完成了为期18个月的试验。在DHEA + COC组中，脊柱和全身aBMD z评分保持不变，但在安慰剂组中下降（比较趋势，分别为P = .008和P = .001）。接受DHEA + COC的受试者骨转换标志物最初下降，然后恢复至基线水平。未观察到身体组成、治疗不良反应或生化安全性参数改变的差异。DHEA + COC联合治疗似乎是安全和有效的预防年轻女性AN的骨丢失，而安慰剂导致aBMD降低。随着扭转AN的营养、心理和其他激素成分的努力的实施，脱氢表雄酮+ COC可以安全地用于保护骨量。
Anorexia nervosa (AN) is characterized by subnormal estrogen and dehydroepiandrosterone (DHEA) levels. We sought to determine whether the combination of DHEA + estrogen/progestin is superior to placebo in preserving skeletal health over 18 months in AN. Females with AN, aged 13 to 27 years, were recruited for participation in this double-blind, placebo-controlled, randomized trial. Ninety-four subjects were randomized, of whom 80 completed baseline assessments and received either study drug (oral micronized DHEA 50 mg + 20 µg ethinyl estradiol/0.1 mg levonorgestrel combined oral contraceptive pill [COC] daily; n = 43) or placebo (n = 37). Serial measurements of areal bone mineral density (aBMD), bone turnover markers, and serum hormone concentrations were obtained. Sixty subjects completed the 18-month trial. Spinal and whole-body aBMD z scores were preserved in the DHEA + COC group, but decreased in the placebo group (comparing trends, P = .008 and P = .001, respectively). Bone turnover markers initially declined in subjects receiving DHEA + COC and then returned to baseline. No differences in body composition, adverse effects of therapy, or alterations in biochemical safety parameters were observed. Combined therapy with DHEA + COC appears to be safe and effective for preventing bone loss in young women with AN, whereas placebo led to decreases in aBMD. Dehydroepiandrosterone + COC may be safely used to preserve bone mass as efforts to reverse the nutritional, psychological, and other hormonal components of AN are implemented.
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DOI：
10.1359/jbmr.090805
发表时间：
2010-02
期刊：
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research
影响因子：
--
作者：
Ecklund K;Vajapeyam S;Feldman HA;Buzney CD;Mulkern RV;Kleinman PK;Rosen CJ;Gordon CM
通讯作者：
Gordon CM
影响因子：
11
作者：
Hebebrand, J;Blum, WF;Remschmidt, H
通讯作者：
Remschmidt, H
影响因子：
3.2
作者：
Caillot-Augusseau, A;Lafage-Proust, MH;Estour, B
通讯作者：
Estour, B
影响因子：
5.8
作者：
Grinspoon, S;Thomas, L;Klibanski, A
通讯作者：
Klibanski, A
DOI：
10.1016/s1083-3188(02)00145-6
发表时间：
2002-06-01
影响因子：
1.8
作者：
Golden, Neville H;Lanzkowsky, Leora;Shenker, I Ronald
通讯作者：
Shenker, I Ronald