Winterhalder L, Eser P, Widmer J, Villiger P M, Aeberli D
Department of Rheumatology and Clinical Immunology/Allergology, Inselspital Bern, Switzerland.
J Musculoskelet Neuronal Interact. 2012 Dec;12(4):224-9.
To determine longitudinal changes in trabecular volumetric BMD (vBMD) at tibia and radius in young depressive patients under antidepressants using pQCT.
PQCT data on 26 patients (22 females, 4 males) on serotonin re-uptake inhibitors (SSRI), and 14 patients (12 females, 2 males) on non-SSRI (10 SNRI, 4 TCA) were obtained at 4% and 66% of radius and tibia at baseline and at 12-month. Depression was assessed by Beck Depression Inventory (BDI) at baseline and follow-up. Wilcoxon tests were performed to find longitudinal changes in bone parameters within each group, Mann-Whitney tests to detect differences between groups.
The two groups were comparable with regard to age, height and BDI. None of the measured bone parameters changed in the SSRI group. In the non-SSRI group trabecular vBMD increased slightly but significantly from baseline to follow-up at radius and tibia (p<0.03). Between group differences were significant for trabecular BMD at the radius. BDI decreased significantly in both groups by the same amount.
Bone properties were found to be stable over 12 months under therapy with SSRIs. Whether SNRI and TCA indeed increase trabecular vBMD need to be shown in larger cohort.
使用外周定量计算机断层扫描（pQCT）测定年轻抑郁症患者在接受抗抑郁药治疗时胫骨和桡骨小梁体积骨密度（vBMD）的纵向变化。
获取了26例使用5-羟色胺再摄取抑制剂（SSRI）的患者（22例女性，4例男性）以及14例使用非SSRI（10例5-羟色胺及去甲肾上腺素再摄取抑制剂，4例三环类抗抑郁药）的患者（12例女性，2例男性）在基线时以及12个月时桡骨和胫骨4%及66%处的pQCT数据。在基线和随访时通过贝克抑郁量表（BDI）评估抑郁情况。进行威尔科克森检验以发现每组内骨参数的纵向变化，进行曼-惠特尼检验以检测组间差异。
两组在年龄、身高和BDI方面具有可比性。SSRI组中所测量的骨参数均未发生变化。在非SSRI组中，桡骨和胫骨的小梁vBMD从基线到随访时略有但显著增加（p<0.03）。两组间桡骨小梁骨密度的差异具有显著性。两组的BDI均显著下降相同幅度。
发现使用SSRI治疗12个月期间骨特性保持稳定。5-羟色胺及去甲肾上腺素再摄取抑制剂和三环类抗抑郁药是否确实会增加小梁vBMD需要在更大的队列中进行验证。
