Misra Madhusmita, Le Clair Marie, Mendes Nara, Miller Karen K, Lawson Elizabeth, Meenaghan Erinne, Weigel Thomas, Ebrahimi Seda, Herzog David B, Klibanski Anne
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114 ; Pediatric Endocrine Unit, Mass General Hospital for Children and Harvard Medical School, Boston, MA 02114.
Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114.
CNS Spectr. 2010 Sep;15(9):579-586. doi: 10.1017/s1092852900000559.
Alterations in serotonin impact bone metabolism in animal models, and selective serotonin reuptake inhibitors (SSRI) have been associated with increased fracture risk in older adults. SSRIs are commonly used in anorexia nervosa (AN), a condition that predisposes to low bone mineral density (BMD). Our objective was to determine whether SSRI use is associated with low BMD in AN.
We examined Z-scores for spine, hip and whole body (WB) BMD, spine bone mineral apparent density and WBBMC/height (Ht) in females with AN 12-21 years old who had never been on SSRIs, on SSRIs for <6 months (<6M) or >6 months (>6M).
Subjects on SSRIs for >6M had lower spine, femoral-neck and WBBMD Z-scores than those on SSRIs for <6M. Hip BMD and WBBMC/Ht Z-scores were lowest in subjects on SSRIs for >6M. Duration of SSRI use, duration since AN diagnosis and duration of amenorrhea inversely predicted BMD, whereas BMI was a positive predictor. In a regression model, duration of SSRI use remained an independent negative predictor of BMD.
Duration of SSRI use >6M is associated with low BMD in AN.
It may be necessary to monitor BMD more rigorously when duration of SSRI use exceeds 6M.
血清素的改变会影响动物模型中的骨代谢，且选择性血清素再摄取抑制剂（SSRI）与老年人骨折风险增加有关。SSRI常用于神经性厌食症（AN），这种疾病易导致低骨密度（BMD）。我们的目的是确定使用SSRI是否与AN患者的低BMD有关。
我们检测了12至21岁从未使用过SSRI、使用SSRI少于6个月（<6M）或超过6个月（>6M）的AN女性患者的脊柱、髋部和全身（WB）BMD的Z值、脊柱骨矿物质表观密度以及WBBMC/身高（Ht）。
使用SSRI超过6个月的受试者的脊柱、股骨颈和WBBMD Z值低于使用SSRI少于6个月的受试者。使用SSRI超过6个月的受试者的髋部BMD和WBBMC/Ht Z值最低。SSRI使用时间、自AN诊断以来的时间以及闭经时间与BMD呈负相关，而BMI是一个正相关预测因素。在回归模型中，SSRI使用时间仍然是BMD的独立负相关预测因素。
使用SSRI超过6个月与AN患者的低BMD有关。
当SSRI使用时间超过6个月时，可能有必要更严格地监测BMD。
