Yeditepe University, Department of Internal Medicine, Section of Endocrinology and Metabolism, Yeditepe Universitesi Hastanesi, Devlet Yolu Ankara Cad. Kozyatagi, Istanbul, Turkey.
J Psychiatr Res. 2011 Oct;45(10):1316-20. doi: 10.1016/j.jpsychires.2011.04.005. Epub 2011 May 4.
Both decrease in bone mineral density and increase in bone turnover had been reported in patients with major depression compared to healthy controls. But the effect of antidepressant treatment on markers of bone turnover is not studied. The aim of this study was to investigate the effect of treatment of a major depressive episode with an SSRI antidepressant on bone turnover in premenopausal women.
Fifty premenopausal female patients with newly diagnosed major depression according to DSM IV-R criteria were included into the study. Before starting antidepressant therapy (escitalopram 10 mg/day) and three months later, blood samples were collected for the measurement of serum calcium, phosphorus, osteocalcin, β-CTX and iPTH. Depressive status was determined with Hamilton Depression Scale.
Treatment of depression did not create any change in laboratory levels of either calcium or phosphorus. Basal iPTH level was significantly decreased with the treatment. Treatment resulted in an increase in serum osteocalcin and decrease in β-CTX levels. HAMD score was significantly correlated with both osteocalcin and β-CTX. The decrease in β-CTX and increase in osteocalcin levels were more prominent in patients with a HAMD score that remained below 15 than above 15 at the end of the study period. In conclusion, this study shows that with the treatment of depression bone formation increases and bone resorption decreases in premenopausal women with major depression.
与健康对照组相比，患有重度抑郁症的患者的骨密度下降和骨转换增加。但是，抗抑郁药治疗对骨转换标志物的影响尚未研究。本研究旨在探讨使用 SSRI 类抗抑郁药治疗绝经前女性重度抑郁症发作对骨转换的影响。
根据 DSM-IV-R 标准，将 50 名新诊断为重度抑郁症的绝经前女性患者纳入研究。在开始抗抑郁治疗（依他普仑 10mg/天）前和 3 个月后，采集血样以测量血清钙、磷、骨钙素、β-CTX 和 iPTH。采用汉密尔顿抑郁量表（Hamilton Depression Scale）评估抑郁状况。
治疗抑郁症并未导致钙或磷的实验室水平发生任何变化。基础 iPTH 水平随治疗而显著降低。治疗导致血清骨钙素增加和 β-CTX 水平降低。HAMD 评分与骨钙素和 β-CTX 均呈显著相关。与研究结束时 HAMD 评分仍低于 15 的患者相比，β-CTX 水平降低和骨钙素水平升高在 HAMD 评分高于 15 的患者中更为明显。总之，本研究表明，在绝经前患有重度抑郁症的女性中，随着抑郁症的治疗，骨形成增加，骨吸收减少。
