Characteristics of bone mineral density in patients with functional hypothalamic amenorrhoea and its association with reproductive hormones and body composition
Authors' conclusion
Fifteen percent of the patients with FHA exhibited low bone mass, a condition associated with prolonged weight loss. The basal LH and TT levels showed positive correlations with LBMD and Fn BMD, respectively. Meanwhile, BMR levels, BMI, BF%, and muscle mass were all positively correlated with LBMD and Fn BMD. Clinically, we should be attentive to suboptimal bone health in patients with FHA and take early screening, diagnosis and intervention measures, especially appropriate muscle mass gain, to prevent the onset of osteoporosis and fragility fractures in the long term.
Study context
- Population
- Female patients with functional hypothalamic amenorrhoea (FHA), Obstetrics and Gynecology Hospital of Fudan University, January 2022 to March 2023; mean age 24.64 ± 6.02 years, body mass index (BMI) 19.47 ± 2.86 kg/m²
- Participants
- 80 patients
- Exposure
- Low bone mass vs normal bone mineral density (BMD)
- Outcome
- BMD (lumbar spine and femoral neck, DXA, Z score) and its association with clinical and endocrine features
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Low BMD at lumbar spine and/or femoral neck
15%
Low bone mass at lumbar spine
12.5%
Low bone mass at femoral neck
10%
Observational data: associations, not effects.
Further findings
Duration of weight loss · longer with low bone mass
P = 0.037
Basal metabolic rate · lower with low bone mass
P = 0.011
Bone mineral content · lower with low bone mass
P = 0.009
Correlates of lumbar spine BMD (LBMD) and femoral neck BMD (Fn BMD)
- LBMD and Fn BMD positively correlated with BMI, BF%, lean body mass (LBM) and regional muscle/fat mass
- all p < .05
- LBMD positively correlated with basal luteinising hormone (LH)
- P = 0.009
- LBMD positively correlated with waist-to-hip ratio
- P = 0.034
- Fn BMD positively correlated with total testosterone (TT)
- P = 0.029
Multiple linear regression
- LBM positively associated with LBMD, β (95% CI 0.004-0.009, p < .001)
- .007
- Trunk muscle mass positively associated with Fn BMD, β (95% CI 0.013-0.080, p = .008)
- .046
Original publication
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