Bone Perspectives in Functional Hypothalamic Amenorrhoea: An Update and Future Avenues.
Bone Perspectives in Functional Hypothalamic Amenorrhoea: An Update and Future Avenues.
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DOI：
10.3389/fendo.2022.923791
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发表时间：
2022
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
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功能性下丘脑闭经（FHA）最重要和潜在的长期有害后果之一是对骨骼稳态的影响。除了雌激素缺乏外，FHA还与一系列额外的神经内分泌和代谢改变有关，有些是适应性的，但联合收割机会破坏骨骼的稳态。最终，这导致FHA女性的骨折风险比健康女性高两倍。尽管FHA相关骨丢失管理的基石仍然是通过恢复代谢/心理平衡来恢复月经，但激素操作（特别强调给药途径）和其他药物治疗可以保护或改善FHA中的骨骼稳态的证据正在迅速发展。在这篇简短的综述中，我们从骨的角度提供了该领域的病理生理学、临床管理和未来途径的最新信息。
One of the most important and potentially long-lasting detrimental consequences of Functional Hypothalamic Amenorrhoea (FHA) is on skeletal homeostasis. Beyond oestrogen deficiency, FHA is associated with a cascade of additional neuro-endocrine and metabolic alterations, some adaptive, but which combine to disrupt skeletal homeostasis. Ultimately, this leads to a two-fold increased risk of fractures in women with FHA compared to healthy eumenorrhoeic women. Although the cornerstone of management of FHA-related bone loss remains recovery of menses via restoration of metabolic/psychological balance, there is rapidly developing evidence for hormonal manipulations (with a particular emphasis on route of administration) and other pharmacological treatments that can protect or improve skeletal homeostasis in FHA. In this mini-review, we provide an update on the pathophysiology, clinical management and future avenues in the field from a bone perspective.