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: 3159595
• 负责人: MICHAEL J PERTSCHUK
• 金额: $ 15.32万
• 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 1994-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3159595
• 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; osteoporosis; 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.

我们以前发现骨密度降低是骨质疏松症 神经性厌食症。这一发现具有严重的影响。自.以来 大多数患者的年龄处于骨量正常的年龄 随着骨量增加，峰值骨量可能会受到影响。许多厌食症患者 患病多年或不能康复的人可能会面临死亡的危险 在生命的相对早期发展成衰弱的骨病。甚至恢复了 厌食者最终患骨病的风险可能会增加。 晚年减少的骨矿物质储备。对骨骼的理解 厌食症的密度问题因缺乏长期治疗而受阻 随访资料和对正常骨发育的有限认识 青春期/青年年龄组。关于正常的许多最新信息 发展源于横断面研究，而不是纵向研究。在……里面 厌食症患者骨密度变化的纵向研究 神经症将在五年内被记录在一系列 治疗结果。一组匹配的正常对照组也将 紧随其后。75名神经性厌食症受试者来自 科室住院服务和80名仔细筛查的正常对照 通过公示招聘将被录入。骨密度将是 通过腰椎和腰椎的双光子吸收测量进行评估 非优势中段的单光子吸收计量学。基线 将获得的值包括血清妊娠试验，雌二醇， 25-羟基-维生素D，钙，无机PO4，碱性磷酸酶，T4，T3Ru，TSH，PTH，BUN， 肌酐、TIBC、总蛋白及24小时尿皮质醇、肌酐。 活动和食物记录以及饮食态度测试将被 完成。厌食症受试者每六个月重复一次评估 而对照组将通过血清妊娠试验重复评估，但不进行 每年进行其他血液或尿液检查。随访的时间长短视情况而定 取决于受试者进入的时间。随访期为24至24小时 54个月，两组中三分之二的人至少有三年 后续行动。将检验有关组间差异的假设 与病程、月经状况和体重有关。假设 将接受与组内体重差异相关的测试， 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中的骨质疏松风险 神经和骨密度恢复的可能程度。 这些发现可能对更全面地了解骨骼疾病有价值。 在青少年/青壮年年龄组。控制数据将提供更多 需要有关骨密度正常发育过程的信息。