Bone Turnover with Venlafaxine Treatment in Older Adults with Depression.
Bone Turnover with Venlafaxine Treatment in Older Adults with Depression.
复制标题
DOI：
10.1111/jgs.14936
复制
发表时间：
2017-09
影响因子：
6.3
通讯作者：
Lenze EJ
中科院分区：
文献类型：
--
作者：
Rawson KS;Dixon D;Civitelli R;Peterson TR;Mulsant BH;Reynolds CF 3rd;Lenze EJ
流行病学数据表明，老年人服用血清素抗抑郁药可能会加速骨质流失。我们在接受抗抑郁治疗的老年人中检查了骨转换标志物的变化和与这些变化相关的患者水平变量。在168名老年抑郁症患者中，我们检测了在文拉法辛治疗12周前后血清中1型胶原c端交联末端肽（CTX）和骨形成标志物1型N前肽（P1NP）的水平。我们还研究了CTX和P1NP的变化是否与抑郁缓解和抑郁持续时间，以及5 -羟色胺转运体（5HTTLPR）和1B受体（HTR1B）的遗传多态性有关。在文拉法辛治疗期间，CTX增加，P1NP降低，这与骨质流失加速一致。两个患者水平的临床变量与骨转换相关：抑郁症未缓解者CTX水平较高，而慢性抑郁症患者P1NP水平较低。HTR1B基因型预测P1NP变化；httlpr基因型与这两种生物标志物无关。骨转换标志物随着抗抑郁药物的治疗而改变，其模式表明骨质流失加速，尽管这些变化的临床意义尚不清楚。这些数据是初步的，需要进行更大规模的对照研究，以确认抗抑郁药是否对骨骼代谢有害，以及某些患者的风险是否会增加。
Epidemiologic data suggest older adults receiving serotonergic antidepressants may have accelerated bone loss. We examined bone turnover marker changes and patient-level variables associated with these changes in older adults receiving protocolized antidepressant treatment. In 168 older adults with major depression, we assayed serum levels of the bone resorption marker C-terminal cross-linking telopeptide of type 1 collagen (CTX), and the bone formation marker procollagen type 1 N propeptide (P1NP) before and after 12 weeks of treatment with venlafaxine. We also examined whether CTX and P1NP changes were associated with depression remission and duration of depression, as well as genetic polymorphisms in the serotonin transporter (5HTTLPR) and 1B receptor (HTR1B). CTX increased and P1NP decreased during venlafaxine treatment, a profile consistent with accelerated bone loss. Two patient-level clinical variables correlated with bone turnover: non-remitters from depression had higher CTX levels, while those with chronic depression had reduced P1NP levels. Additionally, HTR1B genotype predicted P1NP change; 5HTTLPR genotype was unrelated to either biomarker. Bone turnover markers change with antidepressant treatment in a pattern that suggests accelerated bone loss, although the clinical significance of these changes is unclear. These data are preliminary and argue for a larger, controlled study to confirm whether antidepressants are harmful to bone metabolism and whether certain patients might be at increased risk.
登录
查看更多内容
DOI：
10.1016/s0140-6736(15)00308-6
发表时间：
2015-12-12
期刊：
Lancet (London, England)
影响因子：
--
作者：
Lenze EJ;Mulsant BH;Blumberger DM;Karp JF;Newcomer JW;Anderson SJ;Dew MA;Butters MA;Stack JA;Begley AE;Reynolds CF 3rd
通讯作者：
Reynolds CF 3rd
影响因子：
0.9
作者：
Villafuerte SM;Vallabhaneni K;Sliwerska E;McMahon FJ;Young EA;Burmeister M
通讯作者：
Burmeister M
影响因子：
--
作者：
Diem, Susan J.;Blackwell, Terri L.;Ensrud, Kristine E.
通讯作者：
Ensrud, Kristine E.
影响因子：
--
作者：
Haney, Elizabeth M.;Chan, Benjamin K. S.;Bliziotes, Michael
通讯作者：
Bliziotes, Michael
影响因子：
4.3
作者：
Brown, Monique J.;Mezuk, Briana
通讯作者：
Mezuk, Briana