Increased Bone Marrow Fat in Anorexia Nervosa
Increased Bone Marrow Fat in Anorexia Nervosa
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DOI：
10.1210/jc.2008-2532
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发表时间：
2009-06-01
影响因子：
5.8
通讯作者：
Klibanski, Anne
中科院分区：
文献类型：
--
作者：
Bredella, Miriam A.;Fazeli, Pouneh K.;Klibanski, Anne
背景：虽然患有神经性厌食症（AN）的女性有严重的体脂耗竭，但骨髓脂肪却有矛盾的增加。最近的数据表明，在检测骨质疏松方面，通过1H-磁共振波谱（MRS）测量的骨髓脂肪与骨矿物质密度（BMD）相结合可能比单独使用这两个参数更有价值。目的：本研究的目的是利用1H-MRS研究AN对骨髓脂肪在脊柱和股骨中积聚的影响，以及骨髓脂肪与BMD，和身体组成的研究。设计：这是一项横断面研究。设置：研究在转诊中心进行。患者：患者包括10名女性AN（29.8 ± 7.6岁）和10名正常体重年龄匹配的女性（29.2 +/- 5.2岁）。干预措施：没有干预措施。主要结果测量：1H-MRS测量第四腰椎和股骨骨髓脂肪含量，双能X线骨密度仪测量脊柱和髋部骨密度。与对照组相比，AN患者第四腰椎和股骨的骨髓脂肪含量较高（P = 0.004-0.01）。L4和股骨骨髓脂肪与脊柱和髋部骨密度呈负相关（r = -0.56 ~-0.71，P = 0.01-0.0002），体重指数与大腿皮下脂肪呈负相关（r = -0.49 ~-0.71，P = 0.03-0.0007）。股骨骨髓脂肪与sc和腹部总脂肪呈负相关（r = -0.53 ~-0.67，P = 0.003-0.03）。在皮下脂肪和内脏脂肪显著减少的同时，骨髓脂肪却反常地增加，这引起了关于这一过程的功能后果的重要问题。（临床内分泌代谢杂志94：2129-2136，2009）
Context: Although women with anorexia nervosa (AN) have severe depletion of body fat, a paradoxical increase in bone marrow fat has been described. Recent data suggest that marrow fat measured by 1H-magnetic resonance spectroscopy (MRS) in combination with bone mineral density (BMD) may be more valuable than either parameter alone in detecting bone weakness.Objective: The objective of the study was to investigate the effect of AN on accumulation of marrow fat in spine and femur using 1H-MRS and the relationship between marrow fat, BMD, and body composition in subjects with AN and normal-weight controls.Design: This was a cross-sectional study.Setting: The study was conducted at a referral center.Patients: Patients included 10 women with AN (29.8 +/- 7.6 yr) and 10 normal-weight age-matched women (29.2 +/- 5.2 yr).Interventions: There were no interventions.Main Outcomes Measure: Marrow fat content of the fourth lumbar vertebra and femur measured by 1H-MRS. BMD of spine and hip measured by dual-energy x-ray absorptiometry.Results: Subjects with AN had higher marrow fat at the fourth lumbar vertebra and femur compared with controls (P = 0.004-0.01). There was an inverse correlation between marrow fat of L4 and femur and BMD of the spine and hip (r = -0.56 to -0.71, P = 0.01-0.0002) and body mass index and sc adipose tissue of the thigh (r = -0.49 to -0.71, P = 0.03-0.0007). There was an inverse correlation between femur marrow fat and sc and total abdominal adipose tissue (r = -0.53 to -0.67, P = 0.003-0.03).Conclusion: Women with AN have greater lumbar and femoral marrow fat than controls, and marrow fat correlates inversely with BMD. This paradoxical increase in marrow fat at a time when sc and visceral fat are markedly reduced raises important questions about functional consequences of this process. (J Clin Endocrinol Metab 94: 2129-2136, 2009)