Abstract:
OBJECTIVE: To characterize the skeletal, cardiometabolic, cognitive, and mental health phenotype of adolescents with idiopathic premature ovarian insufficiency (POI) DESIGN: Case control SETTING: Pediatric tertiary referral center in Cincinnati, Ohio PARTICIPANTS: Nine adolescents (ages 11-18.99 years) with newly diagnosed POI and 9 normally menstruating controls, matched by age and body mass index MAIN OUTCOME MEASURES: Between-group comparisons of bone characteristics assessed by dual energy x-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), psychosocial health (anxiety, depression, and quality of life), and cognition and memory by questionnaire RESULTS: Adolescents with POI had lower bone density Z-scores by DXA (lumbar spine -1.93 vs 0.80; whole body less head -2.05 vs 0.00; total hip -1.03 vs 0.83; and femoral neck -1.23 vs 0.91; all P < .001), as well as lower trabecular volumetric bone mineral density (tibia 3% site 226 vs 288 mg/mm3, P < .001; radius 3% site 200 vs 251, P = .001), smaller cortical area (tibia 66% site 251 vs 292 mm2, P = .028), and thickness (tibia 66% site 3.56 vs 4.30 mm, P = .001) than controls. No abnormalities in cardiometabolic biomarkers were detected in POI cases. Adolescents with POI were also more likely to report low energy (78% vs 22%, P = .02).
CONCLUSIONS: Estrogen deficiency adversely affects bone health in adolescents with POI. However, we did not find associations with cardiometabolic, mental health, or cognitive outcomes in this small sample.
摘要:
目的:为了表征骨骼,心脏代谢,认知,和心理健康,青少年特发性过早卵巢功能不全(POI)的表型。
方法:病例对照设置:辛辛那提儿科三级转诊中心,俄亥俄州参与者:9名青少年(11-18.99岁)新诊断为POI和9名正常月经对照,年龄和BMI相匹配。
方法:在通过双能X射线吸收法(DXA)和外周定量计算机断层扫描(pQCT)评估的骨骼特征的组比较之间,社会心理健康(焦虑,抑郁症,和生活质量)以及通过问卷调查的认知和记忆。
结果:通过DXA,患有POI的青少年的骨密度Z评分较低(腰椎-1.93vs.0.80;全身少头部-2.05vs.0.00,全髋关节-1.03vs.0.83,股骨颈-1.23vs.0.91,所有p<0.001),以及较低的小梁体积BMD(胫骨3%部位226与288mg/mm3,p<0.001,半径3%部位200与251,p=0.001),皮质面积较小(胫骨66%部位251与292mm2,p=0.028)和厚度(胫骨66%部位3.56与4.30mm,p=0.001)比对照组。在POI病例中未检测到心脏代谢生物标志物的异常。患有POI的青少年也更有可能报告低能量(78%vs.22%,p=0.02)。
结论:雌激素缺乏对患有POI的青少年骨骼健康产生不利影响。然而,我们没有发现与心脏代谢有关,心理健康,或者在这个小样本中的认知结果。