Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses英文文献资料.docVIP

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Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses英文文献资料.doc

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Bone Mineral Density Accrual Determines Energy Expenditure with Refeeding in Anorexia Nervosa and Supersedes Return of Menses英文文献资料

SAGE-HindawiAccesstoResearch JournalofOsteoporosis Volume2011,ArticleID720328,7pages doi:10.4061/2011/720328 ClinicalStudy BoneMineralDensityAccrualDeterminesEnergy ExpenditurewithRefeedinginAnorexiaNervosaand SupersedesReturnofMenses MelissaSum,LaurelMayer,andMichelleP.Warren ColumbiaUniversityCollegeofPhysiciansandSurgeons,622West168thStreet,PH16-128,NewYork,NY10032,USA CorrespondenceshouldbeaddressedtoMelissaSum,ms2452@ Received14August2010;Revised1July2011;Accepted1July2011 AcademicEditor:TomaszMiazgowski Copyright?2011MelissaSumetal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense, whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited. Osteopeniaandosteoporosisaremajorcomplicationsofanorexianervosa(AN).Sinceboneisatissuerequiringlargeamountsof energy,weexaminedthedisproportionateincreaseinrestingenergyexpenditure(REE)thatoccurswithrefeedingofANpatients todetermineifitwasrelatedtoboneaccretion.Thirty-sevenANpatientsaged23.4±4.8yearsunderwentabehavioralweight-gain protocollastingamedianof66days;27remainedamenorrheic,and10regainedmenses.Sixteencontrolsaged25.1± 4. 7years wereage-and%IBWmatchedwithpatients.REEwasmeasuredusingarespiratorychamber-indirectcalorimeter.Signi?cant correlationswerefoundbetweenREEandchangesinspine(r=0.48,P0.02)andleg(r=0.43,P0.05)BMDsinANpatients. Furthersubgroupanalysisoftheamenorrheicsrevealedsigni?cantcorrelationbetweenREEandchangeinspineBMD(r =0.59, P 0.02)andhigherIGF-1afterweightgaincomparedtocontrols.AmenorrheicsalsohadlowerBMDs.These?ndingswere absentintheregainedmensesgroup.TheincreaseinREEseeninwomenwithANduringnutritionalrehabilitationmayberelated toactiveboneformation,whichisnotasprominentwhenmenseshavereturned. 1.Introduction that the increase in REE is a re?ection of lean body mass growth[3],areversaloftheinitialadaptationtomalnutri- tion[4],oradefenseoflowbodyweight[5].Mostpuzzling isthatothershavefoundtheincreaseinREEtobedisp