Relationship between long-term use of a typical antipsychotic medication by Chinese schizophrenia patients and the bone turnover markers serum osteocalcin and β-CrossLaps

Zhang, Beibei; Deng, Lu; Wu, Haishan; Lu, Xiaozi; Peng, Linfeng; Wu, Renrong; Guo, Wenbin; Chen, Jindong; Li, Lehua; Zhao, Jingping

doi:10.1016/j.schres.2016.06.034

Cited by 25 publications

(22 citation statements)

References 23 publications

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“…In our study, all markers of bone turnover are higher. Our results show a significant elevation of serum concentrations of CTX 10 .…”

Section: Discussionsupporting

confidence: 58%

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2017

IJPSR

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Serum markers reflect a bone cell activity that regulate bone remodeling, bone alkaline phosphatase (PAO), Total Intact Procollagen Type I Nterminal propeptide (TP1NP) for training and tartrate-resistant acid phosphatase (TRAPB5), carboxy-terminal collagen crosslinks (Cross Laps) for bone resorption. These markers are sensitive and early tools, Elevated serum levels of these markers is a very good prognostic factor of primary bone tumors as well as monitoring and evaluation tools. We investigated whether biomarkers of bone formation (PAO, P1NP) and bone resorption (CTX and TRAPb5) were modified by chemotherapy. The aim of this study was to evaluate the impact of treatment on serum PAO and TP1NP and TP1NP and TRAPB5. Result: We found a significant correlation between serum levels of training biomarkers (PAO and TP1NP in the group of patients (p = 0.0042) and a strong correlation between PAO and TP1NP In the sick and control groups (p = 0.00027) and a strong correlation between TP1NP and TRAP5b in the groups of patients and controls (p = 0.033). Bone markers can be used in therapeutic monitoring of experimental bone disorders and to assess remodeling during chemotherapy for primary tumors. Recently, the isolation and characterization of several compounds of the bone matrix have enabled the development of new biochemical markers of bone remodeling 6. They use either the measurement of enzyme activity related to the

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“…In our study, all markers of bone turnover are higher. Our results show a significant elevation of serum concentrations of CTX 10 .…”

Section: Discussionsupporting

confidence: 58%

“…A positive association between age and bone turnover markers (PAO, P1NP, CrossLaps, TRAP5b serum) in a population 15 . As well Relate an increase CrossLaps) with age 10 . In our study, all markers of bone turnover are higher.…”

Section: Discussionmentioning

confidence: 61%

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2017

IJPSR

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“…While preliminary data suggest an influence of elevated prolactin levels on bone turnover markers in schizophrenia treated with antipsychotics,175 suggesting that prolactin-raising drugs should reduce bone mineral density,171 more studies are needed to better determine the precise mechanisms underlying the effect of antipsychotics on bone metabolism, as per an SR 176. Alongside with CVD, fractures explained part of the higher mortality with FGAs compared with SGAs in the elderly 121.…”

Section: Methodsmentioning

confidence: 99%

Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review

Solmi

Murru

Pacchiarotti

et al. 2017

TCRM

324

244

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Since the discovery of chlorpromazine (CPZ) in 1952, first-generation antipsychotics (FGAs) have revolutionized psychiatric care in terms of facilitating discharge from hospital and enabling large numbers of patients with severe mental illness (SMI) to be treated in the community. Second-generation antipsychotics (SGAs) ushered in a progressive shift from the paternalistic management of SMI symptoms to a patient-centered approach, which emphasized targets important to patients – psychosocial functioning, quality of life, and recovery. These drugs are no longer limited to specific Diagnostic and Statistical Manual of Mental Disorders (DSM) categories. Evidence indicates that SGAs show an improved safety and tolerability profile compared with FGAs. The incidence of treatment-emergent extrapyramidal side effects is lower, and there is less impairment of cognitive function and treatment-related negative symptoms. However, treatment with SGAs has been associated with a wide range of untoward effects, among which treatment-emergent weight gain and metabolic abnormalities are of notable concern. The present clinical review aims to summarize the safety and tolerability profile of selected FGAs and SGAs and to link treatment-related adverse effects to the pharmacodynamic profile of each drug. Evidence, predominantly derived from systematic reviews, meta-analyses, and clinical trials of the drugs amisulpride, aripiprazole, asenapine, brexpiprazole, cariprazine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, sertindole, ziprasidone, CPZ, haloperidol, loxapine, and perphenazine, is summarized. In addition, the safety and tolerability profiles of antipsychotics are discussed in the context of the “behavioral toxicity” conceptual framework, which considers the longitudinal course and the clinical and therapeutic consequences of treatment-emergent side effects. In SMI, SGAs with safer metabolic profiles should ideally be prescribed first. However, alongside with safety, efficacy should also be considered on a patient-tailored basis.

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“…It can affect bone density in many ways, such as medical condition, unhealthy lifestyle behaviours or, possibly, the prolactin-elevating effects of antipsychotics [6]. Although long-standing hyperprolactinemia can have an impact on the rate of bone metabolism and, when associated with hypogonadism, may lead to decreased bone density in both female and male subjects, the relative contribution of antipsychotic-induced hyperprolactinemia in bone mineral loss in patients with schizophrenia remains unclear [7].…”

Section: Introductionmentioning

confidence: 99%

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

Shen¹,

Li²,

Huang³

et al. 2017

J Osteopor Phys Act

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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.

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Relationship between long-term use of a typical antipsychotic medication by Chinese schizophrenia patients and the bone turnover markers serum osteocalcin and β-CrossLaps

Cited by 25 publications

References 23 publications

Untitled

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Safety, tolerability, and risks associated with first- and second-generation antipsychotics: a state-of-the-art clinical review

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

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