Low bone mass in premenopausal women with depression
Low bone mass in premenopausal women with depression
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DOI：
10.1001/archinte.167.21.2329
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发表时间：
2007-11-26
影响因子：
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通讯作者：
Cizza, Giovanni
中科院分区：
文献类型：
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作者：
Eskandari, Farideh;Martinez, Pedro E.;Cizza, Giovanni
背景资料：低骨密度（BMD）的患病率增加已报告的患者与抑郁症（MDD），大多数women.Methods：研究招募进行了2001年7月1日至2003年2月29日。我们报告了89名绝经前MDD妇女和44名健康对照妇女的基线BMD测量结果，这些妇女参加了一项骨转换的前瞻性研究。采用双能X线骨密度仪测量脊柱、髋部和前臂的骨密度。在一组女性中测量血浆24小时细胞因子、24小时尿游离皮质醇和儿茶酚胺排泄的平均小时水平。我们根据精神障碍诊断和统计手册定义了MDD结果：MDD患者股骨颈低BMD（T评分小于-1）的患病率高于对照组（17% vs 2%; P= 0.02）和全髋关节（15% vs 2%; P= 0.03），腰椎的比例更大（20% vs 9%; P= 0.14）。平均+/- SD BMD（以克/平方厘米表示）在股骨颈MDD女性中较低（0.849 +/- 0.121 vs 0.866 +/- 0.094; P=.05）和腰椎（1.024 +/- 0.117 vs 1.043 +/- 0.092; P= 0.05），并且在桡骨处倾向于更低（0.696 +/- 0.049 vs 0.710 +/- 0.055; P= 0.07）。MDD的妇女有增加的平均水平的24小时促炎细胞因子和抗炎cytokines.Conclusions水平下降：低骨密度是更普遍的绝经前MDD的妇女。BMD缺陷具有临床意义，其程度与骨质疏松症的既定危险因素（如吸烟和钙摄入量减少）所导致的BMD缺陷相当。免疫或炎症失衡对绝经前MDD女性低BMD的可能作用仍有待澄清。
Background: An increased prevalence of low bone mineral density (BMD) has been reported in patients with major depressive disorder (MDD), mostly women.Methods: Study recruitment was conducted from July 1, 2001, to February 29, 2003. We report baseline BMD measurements in 89 premenopausal women with MDD and 44 healthy control women enrolled in a prospective study of bone turnover. The BMD was measured by dual-energy x-ray absorptiometry at the spine, hip, and forearm. Mean hourly levels of plasma 24-hour cytokines, 24-hour urinary free cortisol, and catecholamine excretion were measured in a subset of women. We defined MDD according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition).Results: The prevalence of low BMD, defined as a T score of less than -1, was greater in women with MDD vs controls at the femoral neck (17% vs 2%; P=.02) and total hip (15% vs 2%; P=.03) and tended to be greater at the lumbar spine (20% vs 9%; P=.14). The mean +/- SD BMD, expressed as grams per square centimeters, was lower in women with MDD at the femoral neck (0.849 +/- 0.121 vs 0.866 +/- 0.094; P=.05) and at the lumbar spine (1.024 +/- 0.117 vs 1.043 +/- 0.092; P=.05) and tended to be lower at the radius (0.696 +/- 0.049 vs 0.710 +/- 0.055; P=.07). Women with MDD had increased mean levels of 24-hour proinflammatory cytokines and decreased levels of anti-inflammatory cytokines.Conclusions: Low BMD is more prevalent in premenopausal women with MDD. The BMD deficits are of clinical significance and comparable in magnitude to those resulting from established risk factors for osteoporosis, such as smoking and reduced calcium intake. The possible contribution of immune or inflammatory imbalance to low BMD in premenopausal women with MDD remains to be clarified.