Prevalence and Factors Associated With Decreased Bone Mineral Density in Young and Middle-Aged Male Schizophrenic Patients

Abstract

Objective: The prevalence and factors of decreased bone mineral density (BMD) in young and middle-aged schizophrenic male subjects were examined in this study. Methods:The sample included male patients, diagnosed with schizophrenia, between 18 and 45 years old. In the large-sample, cross-sectional study, cluster sampling method was adopted. 200 male inpatients in total, between 18 and 45 years old, diagnosed with schizophrenia, were included and interviewed in Beijing. The clinical assessment instruments included the Positive and Negative Syndrome Scale (PANSS) and a questionnaire with disease-related investigations and general information. The laboratory measurements concluded calcium, phosphorus, total cholesterol, prolactin (PRL), thyroid stimulating hormone, fT3, T3, fT4, T4, testosterone and fasting blood-glucose (FBG). Dual-energy X-ray absorptiometry was used to test BMD. Results:The prevalence of osteopenia or osteoporosis was 33.5% (n=67). The prevalence of fracture in decreased BMD group was 17.9%12/67, significantly higher than that in the normal BMD group 8.3%11/133(p<0.05). Decreased BMD was associated with PANSS-negative scores, PANSS-total scores, body mass index (BMI), smoking and weight. Multiple logistic regression analysis revealed that BMI and PANSS-negative score had statistically significant difference between two groups. Conclusion:Prevalence of decreased bone mineral density was higher in young and middle-aged male subjects with schizophrenia in China. And the prevalence of fracture was more than twice in the decreased BMD group compared with the normal BMD group. PANSS-negative symptom was a risk factor, while BMI was a protective factor.

Altered levels of BMD, PRL, BAP and TRACP-5b in male chronic patients with schizophrenia

“…1 C). Our findings are consistent with previous studies of Shen, , et al 10 , who reported that male schizophrenic subjects had a higher prevalence of decreased BMD compared with the healthy population in china. Cui, et al 28 also found that BMD decreased remarkably in Chinese patients with schizophrenia.…”

“…BMD and other bone turnover marker levels in schizophrenia patients should be studied in the future. Third, as previous studies has reported, reduced BMD in schizophrenia is associated with several factors such as smoking, physical activity, and alcohol consumption or other substance abuse 1,2,4,10,11 . However, due to the limitations of our study, we did not collect these data , which deserve future investigations.…”

“…It is worth noting that current studies have shown that reduced BMD in patients with schizophrenia is not only associated with elevated serum prolactin levels, but also with many other factors such as smoking, alcohol abuse, vitamin D deficiency and so on 1,2,4,10,11 . More studies without confounding influence of these variables are warranted.…”

“…Although genetically influenced, BMD is also influenced by various other factors including age, alcohol intake, smoking, nutrition, drug use, deficiency of vitamin D and various diseases 1 , 2 , 5 – 8 . Research has found that the risk of osteoporosis and femoral neck fracture in schizophrenia is higher than that of the general population 3 , 9 , 10 . In addition to lack of physical activity, smoking and drinking alcohol, poor nutrition and lack of sunshine, one of the primary reasons that schizophrenia patients are more likely to develop osteoporosis is long-term use of antipsychotics 11 , 12 .…”