Bone cross-sectional geometry in adolescents and young women with anorexia nervosa: a hip structural analysis study
Bone cross-sectional geometry in adolescents and young women with anorexia nervosa: a hip structural analysis study
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DOI：
10.1007/s00198-006-0308-6
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发表时间：
2007-06-01
影响因子：
4
通讯作者：
Gordon, C. M.
中科院分区：
文献类型：
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作者：
DiVasta, A. D.;Beck, T. J.;Gordon, C. M.
前言更好地描述患有神经性厌食症(AN)的青少年的骨骼几何特征可能会提高对这一人群中骨骼缺陷的了解。我们的目的是确定AN青少年的髋关节横断面几何形状和骨强度是否发生改变。方法采用双X射线骨密度仪测量85例AN青少年和61例健康对照的左侧股骨近端全骨密度和体成分。髋关节结构分析(HSA)程序被用来确定股骨颈和股骨干的骨密度、横截面面积(CSA)和截面模数(Z)。结果AN患者股骨颈和股骨干骨密度低于健康对照组(-36%和-29%，p<；0.001)。在这两个地区，患者的骨CsA和Z都较低(-11%至-35%，p<；0.001)。虽然瘦体重与人血清白蛋白变量相关(r=0.001.48至0.58，p<；)，但体脂没有相关性。神经性厌食症患者的整体骨强度指数(-40%，p<；0.001)和相对骨强度指数(-36%，p<；0.001)均低于对照组。结论神经性厌食症患者的抗轴向载荷(CsA)和弯曲载荷(Z)均低于健康对照组。即使在调整瘦质量后，强度特性的差异也是显著的，这表明不仅减少了机械负荷，而且已知的代谢差异可能导致这些患者的骨强度不足。
Introduction Better characterization of bone geometry in adolescents with anorexia nervosa (AN) may improve understanding of skeletal deficits in this population. Our objective was to determine whether hip cross-sectional geometry and bone strength were altered in adolescents with AN.Methods Measurements of the left total proximal femur and body composition were obtained in 85 adolescents with AN and 61 healthy controls by dual X-ray absorptiometry. The Hip Structural Analysis (HSA) program was used to determine aBMD, cross-sectional area (CSA), and section modulus (Z) at the femoral neck and shaft. Strength indices were calculated and corrected for lean mass.Results Femoral neck and shaft aBMD were lower in AN patients than healthy controls (-36% and -29%, p < 0.001). In both regions, bone CSA and Z were lower in AN sufferers (-11 to -35%, p < 0.001). While lean body mass correlated with HSA variables (r = 0.48 to 0.58, p < 0.001), body fat did not. AN sufferers had lower indices of both whole bone strength (-40%, p < 0.001) and relative bone strength (-36%, p < 0.001) than controls.Conclusions Anorexia nervosa sufferers had decreased resistance to axial (CSA) and bending loads (Z) compared with healthy controls. Differences in strength properties were significant even when adjusted for lean mass, suggesting that not only decreased mechanical loading, but also known metabolic differences are likely responsible for deficits in bone strength in these patients.