骨代謝に対する神経性食欲不振の効果

神経性食欲不振は、自己誘発性の飢starのために低重量状態を特徴とする精神疾患です。主に女性に影響を与えるこの障害は、低栄養摂取量の設定でのエネルギー消費を最小限に抑えるホルモン適応に関連しています。これらの適応には、GH耐性、機能的視床下部無月経、および非甲状腺疾患症候群が含まれます。これらの適応は短期生存に有益であるかもしれませんが、女性の85％を超える骨量減少を含む、この障害に関連する重要かつしばしば持続的な罹患率に貢献します。栄養不足へのホルモンの適応をレビューし、基礎障害と関連する骨量の減少の両方について研究されたホルモン治療をレビューし、骨量減少の長期治療の欠如を含む重要な課題を議論します。この慢性障害と回復にもかかわらず、青年として骨量減少を経験する多くの個人は、慢性的な障害と成人期の骨折のリスクが高くなるという事実。

Anorexia nervosa is a psychiatric disease characterized by a low-weight state due to self-induced starvation. This disorder, which predominantly affects women, is associated with hormonal adaptations that minimize energy expenditure in the setting of low nutrient intake. These adaptations include GH resistance, functional hypothalamic amenorrhea, and nonthyroidal illness syndrome. Although these adaptations may be beneficial to short-term survival, they contribute to the significant and often persistent morbidity associated with this disorder, including bone loss, which affects >85% of women. We review the hormonal adaptions to undernutrition, review hormonal treatments that have been studied for both the underlying disorder as well as for the associated decreased bone mass, and discuss the important challenges that remain, including the lack of long-term treatments for bone loss in this chronic disorder and the fact that despite recovery, many individuals who experience bone loss as adolescents have chronic deficits and an increased risk of fracture in adulthood.