Androgen Deficiency and Osteopenia in Anorexia Nervosa

描述（改编自应用程序） 神经性厌食症在年轻女性中越来越普遍。骨质减少 是一种严重的、频繁的、经常是永久性的合并症， 神经性厌食症，导致虚弱的椎骨挤压骨折。的 骨丢失的病理生理学尚不完全清楚， 治疗是存在的在这一人群中发生的骨质减少是独特的， 与绝经后骨质疏松症不同。替代标志物数据 骨转换显示除了增加的骨形成外， 在雌激素缺乏的状态下观察到的吸收。我们的初步数据 表明患有神经性厌食症的女性相对缺乏 合成代谢激素睾酮，已知其刺激骨形成， 体外我们假设睾丸激素缺乏，主要是卵巢癌， 起源，有助于减少骨形成和骨密度， 神经性厌食症这一假设将通过调查是否 给予生理替代剂量的睾酮增加骨密度 骨密度和骨密度的变化。 在本提案的第一阶段，我们计划调查患病率， 女性神经性厌食症雄激素缺乏的发病机制 特别是确定卵巢或肾上腺雄激素是否减少。在 在研究的第二阶段，我们将研究 睾酮缺乏与睾酮补充对骨标志物的影响， 将患有神经性厌食症和睾酮缺乏症的妇女随机接受 生理替代剂量的睾酮或安慰剂，持续12周， 测量骨转换标志物的变化。在研究的第三阶段，我们 将检查给予睾酮对骨密度和身体的影响 马萨诸塞州

DESCRIPTION (adapted from the application) Anorexia nervosa is becoming increasingly common among young women. Osteopenia is a severe, frequent and often permanent comorbid medical complication of anorexia nervosa which results in debilitating vertebral crush fractures. The pathophysiology of the bone loss is incompletely understood, and no effective therapy exists. The osteopenia that occurs in this population is unique and differs from that of postmenopausal osteoporosis. Data of surrogate markers of bone turnover have shown decreased bone formation in addition to increased resorption seen in states of estrogen deficiency. Our preliminary data demonstrate that women with anorexia nervosa have a relative deficiency of the anabolic hormone testosterone which is known to stimulate bone formation in vitro. We hypothesize that testosterone deficiency, primarily of ovarian origin, contributes to the decreased bone formation and bone density seen in anorexia nervosa. This hypothesis will be tested by investigating whether administration of a physiologic replacement dose of testosterone increases bone formation and bone density in this population. In the first phase of this proposal we plan to investigate the prevalence and pathogenesis of androgen deficiency in women with anorexia nervosa and specifically to determine whether ovarian or adrenal androgens are reduced. In the second phase of the study we will investigate the metabolic effects of testosterone deficiency compared with testosterone repletion on bone markers by randomizing women with anorexia nervosa and testosterone deficiency to receive a physiologic replacement dose of testosterone or placebo for 12 weeks and measuring changes in bone turnover markers. In the third phase of the study, we will examine the effects of administering testosterone on bone density and body mass.