GGz Central Psychiatric Centre, PO Box 3051, 3800 DB Amersfoort, The Netherlands.
Eur J Endocrinol. 2012 Dec;167(6):855-63. doi: 10.1530/EJE-12-0521. Epub 2012 Sep 25.
To investigate the long-term effects of antipsychotic (AP) treatment and AP-induced hyperprolactinemia on bone mineral density (BMD) and body composition in male adolescents with autism spectrum disorders (ASDs) and/or disruptive behavior disorder (DBD).
Physically healthy 10- to 20-year-old boys with ASD and/or DBD, chronically treated (n=56; mean 52 months, range 16-126 months) or not treated (n=47) with an AP, were recruited to this observational study. Prolactin levels and biochemical bone parameters were measured and BMD of the lumbar spine and total body, and body composition were assessed by dual-energy X-ray absorptiometry, and volumetric BMD of the lumbar spine calculated. Group differences were tested with Student's t-test, χ(2) test, Fisher exact test, and logistic regression analysis.
Forty-nine percent of the boys treated with an AP had hyperprolactinemia. The mean volumetric lumbar spine BMD z-score was lower (P=0.043), the total percentage of body fat z-score was higher (P=0.042), and biochemical bone marker carboxyterminal cross-linking telopeptide of bone collagen was lower in the AP-treated boys with hyperprolactinemia than in the AP-treated boys without hyperprolactinemia. Seven to 11% of the hyperprolactinemic boys had low BMD. The mean lumbar spine and total body BMD z-scores and body composition were similar in the boys who were or were not treated with an AP. The total study population had a lower mean lean tissue mass (mean z-score -0.37, P=0.004) and a higher percentage of total body fat (mean z-score 1.16, P<0.001) than healthy controls (normative data); biochemical bone parameters were within normal limits.
AP-induced hyperprolactinemia in boys with ASD or DBD may have a negative effect on lumbar spine BMD. Longitudinal studies are needed to confirm this finding and further disentangle the effects of the disorder, lifestyle, treatment, and hyperprolactinemia.
研究抗精神病药物（AP）治疗及 AP 引起的高催乳素血症对男性自闭症谱系障碍（ASD）和/或破坏性行为障碍（DBD）青少年的骨密度（BMD）和身体成分的长期影响。
本观察性研究招募了 10 至 20 岁的身体健康的 ASD 和/或 DBD 男性青少年，他们接受了（n=56；平均 52 个月，范围 16-126 个月）或未接受（n=47）AP 治疗。测量催乳素水平和生化骨参数，并通过双能 X 射线吸收法评估腰椎和全身的 BMD，以及通过体脂分析仪评估身体成分，并计算腰椎容积 BMD。采用学生 t 检验、χ(2)检验、Fisher 确切检验和逻辑回归分析比较组间差异。
接受 AP 治疗的男孩中有 49%出现高催乳素血症。高催乳素血症的 AP 治疗男孩的平均腰椎容积 BMD z 评分较低（P=0.043），总体脂百分比 z 评分较高（P=0.042），骨胶原羧基末端交联肽的生化骨标志物较低。7-11%的高催乳素血症男孩存在低 BMD。有或没有接受 AP 治疗的男孩的腰椎和全身 BMD z 评分和身体成分相似。总研究人群的瘦组织质量平均值（z 评分-0.37，P=0.004）较低，体脂百分比平均值（z 评分 1.16，P<0.001）较高，与健康对照组（参考数据）相比；生化骨参数均在正常范围内。
ASD 或 DBD 男孩的 AP 引起的高催乳素血症可能对腰椎 BMD 有负面影响。需要进行纵向研究以证实这一发现，并进一步阐明疾病、生活方式、治疗和高催乳素血症的影响。
