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绝经后精神分裂症女性骨矿物质密度降低的相关因素。

Factors associated with decreased bone mineral density in postmenopausal women with schizophrenia.

作者信息

Liang Ying, Huang Jian, Tian Jing-bin, Cao Yuan-yuan, Zhang Guo-ling, Wang Chun-gang, Cao Ying, Li Jian-rong

机构信息

National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Institute of Mental Health, and the Key Laboratory of Mental Health, Ministry of Health, Peking University, Beijing, People's Republic of China.

Psychiatry Department, Changping District Hospital of Integrated Chinese and Western Medicine, Beijing, People's Republic of China.

出版信息

Clin Interv Aging. 2016 Feb 17;11:153-7. doi: 10.2147/CIA.S100274. eCollection 2016.

Abstract

OBJECTIVE

This study examined the risk factors for decreased bone mineral density (BMD) in postmenopausal women with schizophrenia.

METHODS

Cluster sampling method was adopted in this large-sample, cross-sectional study. A total of 219 postmenopausal female inpatients with schizophrenia were selected and interviewed in Beijing. The average age of the patients was 60.4±7.0 years. Clinical assessment instruments included the Positive and Negative Syndrome Scale (PANSS) and a questionnaire with detailed general information and disease-related investigations. Laboratory measurements included prolactin (PRL), estradiol, progesterone, thyroid stimulating hormone, FT3, and FT4. BMD testing was performed by dual-energy X-ray absorptiometry.

RESULTS

The prevalence of osteoporosis or osteopenia was 66.2% (n=145). Decreased BMD was associated with age, illness duration, therapeutic dose (equivalent chlorpromazine dose), treatment duration, PANSS-negative scores, body mass index (BMI), daily exercises (min/d), drinking (unit/wk), PRL, and estradiol. Multiple logistic regression analysis revealed that age, treatment duration, PANSS-negative score, BMI, and PRL were significantly associated with decreased BMD.

CONCLUSION

Prevalence of BMD loss was higher in Chinese postmenopausal women with schizophrenia compared to the normal BMD group. A combination of demographic and clinical factors play important roles in determining decreased BMD, including older age, longer treatment duration, more PANSS-negative scores, higher BMI, and higher PRL level.

摘要

目的

本研究调查了绝经后精神分裂症女性骨密度(BMD)降低的危险因素。

方法

本大样本横断面研究采用整群抽样方法。在北京选取了219例绝经后精神分裂症女性住院患者并进行访谈。患者的平均年龄为60.4±7.0岁。临床评估工具包括阳性和阴性症状量表(PANSS)以及一份包含详细一般信息和疾病相关检查的问卷。实验室检测包括催乳素(PRL)、雌二醇、孕酮、促甲状腺激素、FT3和FT4。采用双能X线吸收法进行骨密度检测。

结果

骨质疏松或骨量减少的患病率为66.2%(n = 145)。骨密度降低与年龄、病程、治疗剂量(氯丙嗪等效剂量)时长、PANSS阴性评分、体重指数(BMI)、日常锻炼(分钟/天)、饮酒(单位/周)、PRL和雌二醇有关。多元逻辑回归分析显示,年龄、治疗时长、PANSS阴性评分、BMI和PRL与骨密度降低显著相关。

结论

与正常骨密度组相比,中国绝经后精神分裂症女性骨密度降低的患病率更高。人口统计学和临床因素共同在决定骨密度降低方面发挥重要作用,包括年龄较大、治疗时间较长、PANSS阴性评分较多、BMI较高和PRL水平较高。

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Clozapine protects bone mineral density in female patients with schizophrenia.氯氮平可保护女性精神分裂症患者的骨密度。
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Skeletal status in psychotic disorders: a population-based study.精神障碍患者的骨骼状况:一项基于人群的研究。
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