Effect of age and disease on bone mass in Japanese patients with schizophrenia

Abstract

BackgroundThere have been a limited number of studies comparing bone mass between patients with schizophrenia and the general population. The aim of this study was to compare the bone mass of schizophrenia patients with that of healthy subjects in Japan.MethodsWe recruited patients (n = 362), aged 48.8 ± 15.4 (mean ± SD) years who were diagnosed with schizophrenia or schizoaffective disorder based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). Bone mass was measured using quantitative ultrasound densitometry of the calcaneus. The osteosono-assessment index (OSI) was calculated as a function of the speed of sound and the transmission index. For comparative analysis, OSI data from 832 adults who participated in the Iwaki Health Promotion Project 2009 was used as representative of the general community.ResultsMean OSI values among male schizophrenic patients were lower than those in the general population in the case of individuals aged 40 and older. In females, mean OSI values among schizophrenic patients were lower than those in the general community in those aged 60 and older. In an analysis using the general linear model, a significant interaction was observed between subject groups and age in males.ConclusionsOlder schizophrenic patients exhibit lower bone mass than that observed in the general population. Our data also demonstrate gender and group differences among schizophrenic patients and controls with regard to changes in bone mass associated with aging. These results indicate that intervention programs designed to delay or prevent decreased bone mass in schizophrenic patients might be tailored according to gender.

A meta-analysis of prevalence estimates and moderators of low bone mass in people with schizophrenia

“…The overall pooled prevalence of osteoporosis in schizophrenia incorporating 17 studies ( n = 2671) was 13.2% [CI = 7.8–21.6%; Q = 299.79 , P ≤ 0.0001, I 2 = 94.6%]. Neither the Begg‐Mazumdar Kendall's τ (−0.117, P = 0.5) or the Egger's bias tests (−1.6, P = 0.3) demonstrated any evidence of publication bias.…”

“…The initial electronic search yielded 689 valid hits and 19 studies were included in the meta‐analysis . At the full text viewing stage, we contacted the authors of 25 publications and, of these, eight studies were subsequently included (five authors provided additional data, see acknowledgements, and three authors did not respond, but contained sufficient data within the paper to enable inclusion), and 17 were excluded due to insufficient data.…”

“…The mean age of participants was 42.7 years [range: 24.5 to 59.1 years] and the mean percentage of males was 59.2%. Eight studies were conducted in Asia , seven in Europe , and four in North America . Eight studies ( n = 1883) were conducted in in‐patient settings, six included out‐patients ( n = 525), four studies included participants from mixed settings ( n = 545), and the setting was unclear in one study ( n = 85).…”

“…Of the 19 studies, 14 utilized a DXA scanner ( n = 828 with schizophrenia) and five studies used QUS ( n = 2210 with schizophrenia).…”

“…Only eight studies had a control group, but one was not matched for age and was excluded from pooled analysis comparing patients with controls (aim 2). In total, seven studies involving 746 participants with schizophrenia [mean age range: 24.5 to 58.2 years; percentage of males: 0–100%] and 1126 age‐ and sex‐matched controls [mean age range: 23.7 to 59.0 years; percentage of males: 0–100%] were included in the comparative meta‐analysis (aim 2). Details of the prevalence of low bone mass, osteoporosis, and osteopenia from each study are summarized in Table .…”