Medical Sciences
Bone Mineral Density in Women with Functional Hypothalamic Amenorrhea: A Systematic Review and Meta-Analysis
By Zhanat Sultanova, Saule Issenova, Yelena Dissyukeyeva and 5 others.
Abstract
This study aims to quantitatively evaluate bone mineral density (BMD) in women with functional hypothalamic amenorrhea (FHA), determine differences across skeletal sites, and summarise current evidence on the diagnosis and management of impaired bone health in this population.
Methods
A systematic search of comparative studies evaluating BMD by dual-energy X-ray absorptiometry (DXA) in women with FHA or anorexia nervosa (AN) and healthy eumenorrhoeic controls was performed. Eleven studies met the eligibility criteria, five of which were included in the meta-analysis. The quantitative synthesis comprised 14 group comparisons, with lumbar spine and hip BMD analysed separately. Effect sizes were pooled using Hedges’ g with 95% confidence intervals (CI) under a random-effects model. Sensitivity analyses using REML estimation with Hartung–Knapp adjustment and leave-one-out analyses were performed to assess the robustness of the pooled estimates.
