Milovanovic Dragan R, Stanojevic Pirkovic Marijana, Zivancevic Simonovic Snezana, Matovic Milovan, Djukic Dejanovic Slavica, Jankovic Slobodan M, Ravanic Dragan, Petronijevic Milan, Ignjatovic Ristic Dragana, Mladenovic Violeta, Jovanovic Mirjana, Nikolic Labovic Sandra, Pajovic Marina, Djokovic Danijela, Petrovic Dusan, Janjic Vladimir
Department of Pharmacology, Toxicology and Clinical Pharmacology, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
Department of Biochemistry, Faculty of Medical Sciences University of Kragujevac, Clinical Centre "Kragujevac", Kragujevac, Serbia.
Psychiatry Investig. 2016 Jan;13(1):89-101. doi: 10.4306/pi.2016.13.1.89. Epub 2015 Oct 14.
Serum parameters of calcium homeostasis were measured based on previously published evidence linking osteoporotic fractures and/or bone/mineral loss with antipsychotics.
Prospective, four-week, time-series trial was conducted and study population consisted of patients of both genders, aged 35-85 years, admitted within the routine practice, with acute psychotic symptoms, to whom an antipsychotic drug was either introduced or substituted. Serial measurements of serum calcium, phosphorous, magnesium, 25(OH)D, parathyroid hormone, calcitonin, osteocalcin and C-telopeptide were made from patient venous blood samples.
Calcium serum concentrations significantly decreased from baseline to the fourth week (2.42±0.12 vs. 2.33±0.16 mmol/L, p=0.022, n=25). The mean of all calcemia changes from the baseline was -2.6±5.7% (-24.1 to 7.7) with more decreases than increases (78 vs. 49, p=0.010) and more patents having negative sum of calcemia changes from baseline (n=28) than positive ones (n=10) (p=0.004). There were simultaneous falls of calcium and magnesium from baseline (63/15 vs. 23/26, p<0.001; OR=4.75, 95% CI 2.14-10.51), phosphorous (45/33 vs. 9/40, p<0.001; 6.06, 2.59-14.20) and 25(OH)D concentrations (57/21 vs. 13/35, p<0.001; 7.31, 3.25-16.42), respectively. Calcemia positively correlated with magnesemia, phosphatemia and 25(OH)D values. Parathyroid hormone and C-telopeptide showed only subtle oscillations of their absolute concentrations or changes from baseline; calcitonin and osteocalcin did not change. Adjustment of final calcemia trend (depletion/accumulation) for relevant risk factors, generally, did not change the results.
In patients with psychotic disorders and several risks for bone metabolism disturbances antipsychotic treatment was associated with the decrease of calcemia and changes in levels of the associated ions.
基于先前发表的将骨质疏松性骨折和/或骨/矿物质流失与抗精神病药物联系起来的证据，测量钙稳态的血清参数。
进行了一项为期四周的前瞻性时间序列试验，研究人群包括年龄在35 - 85岁之间、因急性精神病症状在常规诊疗中入院且开始使用或更换抗精神病药物的男女患者。从患者静脉血样本中对血清钙、磷、镁、25(OH)D、甲状旁腺激素、降钙素、骨钙素和C - 末端肽进行系列测量。
血清钙浓度从基线到第四周显著下降（2.42±0.12 vs. 2.33±0.16 mmol/L，p = 0.022，n = 25）。所有血钙变化相对于基线的平均值为 -2.6±5.7%（-24.1至7.7），下降的情况多于上升的情况（78对49，p = 0.010），且血钙变化总和为负的患者（n = 28）多于为正的患者（n = 10）（p = 0.004）。血钙与血镁、血磷和25(OH)D值呈正相关。甲状旁腺激素和C - 末端肽仅显示出其绝对浓度或相对于基线的变化有细微波动；降钙素和骨钙素没有变化。针对相关风险因素对最终血钙趋势（消耗/积累）进行调整，总体上并未改变结果。
在患有精神障碍且有多种骨代谢紊乱风险的患者中，抗精神病药物治疗与血钙降低以及相关离子水平变化有关。
