LONGITUDINAL STUDY OF BONE DENSITY IN ANOREXIA NERVOSA

神经性厌食症骨密度的纵向研究

• 批准号: 2079553
• 负责人: MICHAEL J PERTSCHUK
• 金额: $ 14.85万
• 依托单位: GRADUATE HOSPITAL (PHILADELPHIA)
• 依托单位国家: 美国
• 财政年份: 1989
• 资助国家: 美国
• 起止时间: 1989-08-25 至 1995-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2079553
• 关键词: 25 hydroxycholecalciferol; alcoholic beverage consumption; anorexia nervosa; blood chemistry; body weight; bone density; calcium metabolism; cortisol; disease /disorder proneness /risk; epidemiology; estradiol; ethnic group; exercise; female; health behavior; human subject; longitudinal human study; menstrual cycle; musculoskeletal disorder diagnosis; nutrition disorder diagnosis; nutrition related tag; osteoporosis; photon absorptiometry; tobacco abuse; urinalysis

We previously identified decreased bone density as a complication of anorexia nervosa. There are serious implications to this finding. Since the majority of patients are at an age when bone mass is normally increasing, peak bone mass may be compromised. The many anorectics who remain ill for years or who do not recover could be at jeopardy for de- veloping debilitating bone disease relatively early in life. Even recovered anorectics could be at increased risk of eventually developing bone disease later in life from reduced bone mineral stores. Understanding of bone density problems in anorexia is hampered by the absence of long term follow-up data and the limited knowledge of normal bone development in the adolescent/young adult.age group. Much current information on normal development derives fran cross sectional rather than longitudinal study. In the proposed longitudinal investigation bone density changes in anorexia nervosa will be documented over a five year period across a range of treatment outcomes. A group of matched normal controls also will be followed. Seventy-five subjects with anorexia nervosa drawn from the departmental inpatient service and 80 carefully screened normal controls recruited through public notice will be entered. Bone density will be evaluated by means of dual photonabsorpticmetry of the lumbar spine and single photon absorptiometry of the non-dominant mid-radius. Baseline values will be obtained including serum pregnancy test, estradiol, 25-OH-Vit D, Ca, inorganic PO4, alk phosphatase, T4, T3Ru, TSH, PTH, BUN, creatinine, TIBC, total protein and 24 hour urine cortisol and creatinine. Activity and food logs together with the Eating Attitudes Test will be completed. Anorectic subjects will repeat the evaluation every six months and controls will repeat evaluations with serum pregnancy tests but without other blood or urine studies annually. Length of follow-up will vary depending on time of subject entry. Follow-up period will range from 24 to 54 months with two-thirds of both groups having at least three years follow-up. Hypotheses will be tested concerning between group differences related to duration of illness, menstrual status, and weight. Hypotheses will be tested related to within group differences regarding weight, menstrual status, exercise, vitamin D, Ca, cortisol, and estradiol. Results will permit better assessment of the risk of osteoporosis in anorexia nervosa and the extent to which recovery of bone density is possible. Findings may have value in the more general understanding of bone disease in the adolescent/young adult age group. Control data will provide much needed information on the normal course of bone density development.

我们以前确定骨密度降低是骨关节炎的并发症， 神经性厌食症 这一发现有严重的影响。以来 大多数患者处于骨量正常的年龄 增加的峰值骨量可能会受到影响。许多厌食症患者 年复一年，或者说，没有一个人，可以说是一个人，可以说是一个人。 在生命的相对早期就发现使人衰弱的骨骼疾病。即使恢复了 减食欲药可能会增加最终发生骨病的风险 骨矿物质储存减少的影响。了解骨骼 厌食症的密度问题受到缺乏长期 随访数据和对正常骨发育的有限了解， 青少年/年轻成人。年龄组。关于正常的许多当前信息 发展源自法国的横向研究，而不是纵向研究。在 建议纵向调查厌食症患者骨密度变化 将在五年的时间内记录一系列神经性疾病， 治疗结果。一组匹配的正常对照也将被 跟踪了75名神经性厌食症受试者来自 80名经过仔细筛选的正常对照者 通过公示招聘的人员将进入。骨密度将是 通过腰椎双光子吸收测定法进行评价， 单光子吸收测量法的非优势中半径。基线 将获得包括血清妊娠试验，雌二醇， 25-OH-Vit D，Ca，无机PO 4，碱性磷酸酶，T4，T3 Ru，TSH，PTH，BUN， 肌酐、总胆红素、总蛋白和24小时尿皮质醇和肌酐。 活动和食物日志以及饮食态度测试将被 完成厌食症受试者将每六个月重复一次评估 对照组将用血清妊娠试验重复评价，但不 每年进行其他血液或尿液检查。随访时间长短将有所不同 取决于受试者进入的时间。随访期为24- 54个月，两组中有三分之二的人至少有三年 随访将检验关于组间差异的假设 与病程、月经状况和体重有关。假设 将测试与体重相关的组内差异， 月经状况、运动、维生素D、钙、皮质醇和雌二醇。结果 将允许更好地评估厌食症患者骨质疏松症的风险 神经和骨密度恢复的程度是可能的。 这些发现可能有助于更全面地了解骨骼疾病 在青少年/年轻成人年龄组。控制数据将提供许多 需要关于骨密度正常发展过程的信息。