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首页> 外文期刊>Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research >Effects of child- and adolescent-onset endogenous Cushing syndrome on bone mass, body composition, and growth: a 7-year prospective study into young adulthood.
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Effects of child- and adolescent-onset endogenous Cushing syndrome on bone mass, body composition, and growth: a 7-year prospective study into young adulthood.

机译：儿童和青少年期内源性库欣综合征对骨量，身体成分和生长的影响：一项对成年后7年的前瞻性研究。

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The long-term effects on bone and fat mass in children with endogenous CS are unknown. In 14 children followed for 3-7 years into young adulthood after cure of CS, whereas bone mass largely recovered, persisting increases in total body and visceral fat suggests an increase risk of the metabolic syndrome. INTRODUCTION: Endogenous Cushing syndrome (CS) is associated with decreased bone mass and increased central fat mass. Whereas bone mass seems to improve after successful treatment, little is known about whether central fat persists. MATERIALS AND METHODS: This was a prospective study of 14 children (10 girls and 4 boys) and adolescents with CS who were successfully treated and remained eucortisolemic. Growth, puberty, bone mass, and body composition were evaluated at baseline and during regular follow-up for 3 years and in seven children for a further 4 years of remission to assess final adult height (FH), BMI, bone mass, and body composition. RESULTS: CS compromised growth, leading to about a -0.8 SD loss of FH and 0.9 SD increase in weight and BMI. BMD apparent density (BMAD) SD Score (SDS) at the lumbar spine (LS) at diagnosis were -1.8 and -1.25, respectively, and after 3 years of follow-up approached the mean with no further increase apparent up to 7 years of follow-up. Whereas hip BMD SDS increased from -1.3 at diagnosis to -0.40 at 3 years and 0 at 7 years of follow-up, femoral neck BMAD remained at or around 0 SDS at diagnosis and during follow-up. BMI was >25 kg/m(2) in five of seven adult subjects, most of whom were women. Total body fat and the ratio of visceral to subcutaneous was abnormally high in the majority of these subjects, whereas LS volumetric BMD was -0.7 SDS. CONCLUSIONS: Despite remission of CS, children and adolescents have significant alterations in body composition that result in a small but significant decrease in bone mass and increase in visceral adiposity. Although bone mass largely recovers after endogenous CS, changes in total and visceral fat suggest these subjects are at increased risk of the metabolic syndrome. Therefore, long-term monitoring of body fat and bone mass is mandatory after treatment of CS.
机译：内源性CS对儿童骨骼和脂肪块的长期影响尚不清楚。在CS治愈后，有14名儿童进入了成年后的3-7年，而骨量大体上恢复了，体内和内脏脂肪的持续增加表明代谢综合征的风险增加。简介：内源性库兴综合征（CS）与骨量减少和中央脂肪量增加有关。尽管成功治疗后骨量似乎有所改善，但对中央脂肪是否持续知之甚少。材料与方法：这是一项前瞻性研究，对14例儿童（10例女孩和4例男孩）和CS的青少年进行了成功的治疗，并保持了奥昔洛韦治疗。在基线和3年的定期随访期间评估生长，青春期，骨骼质量和身体成分，并在7名患儿进一步缓解4年的情况下评估其生长状况，以评估最终成人身高（FH），BMI，骨骼质量和身体组成。结果：CS损害了生长，导致FH损失-0.8 SD，体重和BMI增加0.9 SD。诊断时腰椎（LS）的BMD表观密度（BMAD）SD评分（SDS）分别为-1.8和-1.25，经过3年的随访达到平均值，在7年的随访中没有进一步增加跟进。髋关节BMD SDS从诊断时的-1.3增加到随访的3年的-0.40和随访的7年的0，而股骨颈BMAD在诊断时和随访期间仍保持在0 SDS左右。在七个成年受试者中，有五个是BMI> 25 kg / m（2），其中大多数是女性。在大多数这些受试者中，总脂肪和内脏与皮下的比率异常高，而LS体积BMD为-0.7 SDS。结论：尽管CS缓解，但儿童和青少年的身体组成发生了显着变化，导致骨量轻微但显着减少，内脏脂肪增加。尽管内源性CS后骨量大量恢复，但总脂肪和内脏脂肪的变化表明这些受试者罹患代谢综合征的风险增加。因此，CS治疗后必须长期监测体内脂肪和骨量。

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