Bone mass in schizophrenia and normal populations across different decades of life

Renn, Jenn Huei; Yang, Nan Ping; Chueh, Ching Mo; Lin, Cheng‐I; Lan, Tsuo Hung; Chou, Pesus

doi:10.1186/1471-2474-10-1

Cited by 75 publications

(89 citation statements)

References 39 publications

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“…Several studies have suggested that schizophrenia as a brain disease may be associated with low bone mass and with changes in bone remodeling [1,2,3,4]. Rapid advances are taking place in bone biology.…”

Section: Introductionmentioning

confidence: 99%

Bone Remodeling, Bone Mass and Weight Gain in Patients with Stabilized Schizophrenia in Real-Life Conditions Treated with Long-Acting Injectable Risperidone

Doknic¹,

Maric²,

Britvić³

et al. 2011

Neuroendocrinology

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Background: Prolactin-raising antipsychotics, risperidone (antidopaminergic activity), may be associated with low bone mass. On the other hand, risperidone may cause an increase in body weight thought to be favorable for bone. Objectives: (1) To determine bone remodeling parameters and bone mass in patients with schizophrenia on long-term treatment with long-acting injectable risperidone (LAIR) in naturalistic settings, and (2) to evaluate the change in body weight, metabolic profile and neuroendocrine status in these patients. Design: This was a prospective, cross-sectional study. Patients: Patients included 26 outpatients with controlled schizophrenia in real-life conditions (age 31.3 ± 1.3 years, BMI 28.1 ± 1.0) on long-term maintenance therapy with LAIR for a mean of 18.0 ± 1.6 months (range 6–36) with a mean dose of 38 ± 2 mg. 35 subjects matched for sex, age, BMI and education served as healthy controls. Methods: Serum osteocalcin, C-terminal telopeptide of type I collagen (CTx), vitamin D, leptin, prolactin, sex steroids, and parathyroid hormone were assessed. Indices of insulin sensitivity and resistance were determined following an oral glucose tolerance test (OGTT). Bone mineral density (BMD) was measured by dual X-ray absorptiometry at the lumbar spine (LS) and femoral neck (FN). Results: Mild to moderate hyperprolactinemia (1,000–2,000 mU/l) was associated with asymptomatic hypogonadism. Prolactin values >2,000 mU/l occurred in a few female patients. Hypogonadism leads to a slight increase (upper limit of normal) in bone resorption marker (CTx) in patients with schizophrenia (p = 0.023). As for bone mass, although lower at the spine than in healthy subjects, it did not reach statistical significance (p = 0.094), while at the FN, BMD was not different from healthy subjects. Body weight increased on average 8.7 ± 1.6 kg in more than 50% of patients. Leptin levels adjusted for BMI in females were significantly higher in patients than in healthy female subjects (p = 0.018), while in males there was no difference between the groups (p = 0.833). A high prevalence of low vitamin D levels and more current smokers were found in patients with schizophrenia. As for the metabolic profile during treatment with risperidone, the low Matsuda index of insulin sensitivity (p = 0.039) confirmed insulin resistance in these patients. Conclusion: A potential long-term consequence of asymptomatic hypogonadism due to risperidone-induced hyperprolactinemia might cause a slight rise in bone resorption marker (CTx). On the other hand, by increasing body weight, risperidone could have a protective effect on the bone and thus no change in bone mass was recorded when compared with healthy controls.

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Section: Introductionmentioning

confidence: 99%

Bone Remodeling, Bone Mass and Weight Gain in Patients with Stabilized Schizophrenia in Real-Life Conditions Treated with Long-Acting Injectable Risperidone

Doknic¹,

Maric²,

Britvić³

et al. 2011

Neuroendocrinology

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“…at this period of time. Each of these factors or their common effect may cause peak bone mineral density remain at a lower level (30). This may explain lower bone mineral density of our patients although they are less than 45 years old.…”

Section: Discussionmentioning

confidence: 74%

Comparison of bone mineral density levels in young-adult patients with schizophrenia and healthy controls / Genç-erişkin şizofreni hastalarında kemik mineral yoğunluğu düzeyinin sağlıklı kontrollerle karşılaştırılması

Koçer¹,

Yazıcı²,

Canan³

2011

Dusunen Adam

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Objective: The aim of this study was to assess bone mineral density levels of patients with schizophrenia and to compare the results with healthy controls. Methods: Fourteen patients with schizophrenia and 31 healthy controls, between 22 and 44 years of age, were enrolled in this cross-sectional study. Bone mineral density (BMD) levels of each group were measured by Dual Energy X-ray Absorbiometry (DEXA). The patients were assessed using the Positive and Negative Symptom Scale (PANSS). All patients had been receiving antipsychotic treatment for at least 2 years. Patients' sociodemographic caharacteristics and risk factors for osteoporosis (antipsychotic use, sunlight exposure, physical activity, etc.) were documented. Results: As compared with the healthy controls, the patients with schizophrenia had significantly lower BMD at the lumbar spine and at all sites of the proximal femur. Correlation analysis showed that the only factor related with the femoral BMD only in patients with schizophrenia was the age. No association between BMD and gender, PANSS score, type of antipsychotic medications, and other risk factors for osteoporosis were observed. Conclusions: In this study, we found that BMD in schizophrenia patients was lower than that of healthy controls and this finding suggest that osteoporotic changes may be seen in younger ages. Further prospective studies are needed to better clarify the relationship between osteoporosis and schizophrenia.

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“…It is noteworthy that another gene that modulates the BMP signaling system and is expressed in the brain, TNFRSF11B, was the fourth (GC-RMA, Tukey summarization) and ninth (RMA, Tukey summarization) most differentially expressed gene. Alterations in the BMP signaling system might be expected to have pleiotropic effects, such as observation of a possible comorbidity of SZ and low bone density (Hummer et al, 2005;Renn et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Olfactory neuroepithelium-derived neural progenitor cells as a model system for investigating the molecular mechanisms of neuropsychiatric disorders

Evgrafov¹,

Wrobel

Kang³

et al. 2011

Psychiatric Genetics

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Bone mass in schizophrenia and normal populations across different decades of life

Cited by 75 publications

References 39 publications

Bone Remodeling, Bone Mass and Weight Gain in Patients with Stabilized Schizophrenia in Real-Life Conditions Treated with Long-Acting Injectable Risperidone

Bone Remodeling, Bone Mass and Weight Gain in Patients with Stabilized Schizophrenia in Real-Life Conditions Treated with Long-Acting Injectable Risperidone

Comparison of bone mineral density levels in young-adult patients with schizophrenia and healthy controls / Genç-erişkin şizofreni hastalarında kemik mineral yoğunluğu düzeyinin sağlıklı kontrollerle karşılaştırılması

Olfactory neuroepithelium-derived neural progenitor cells as a model system for investigating the molecular mechanisms of neuropsychiatric disorders

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