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双相情感障碍与低骨量之间的关联:一项针对新诊断的、未用药患者的横断面研究。

Association Between Bipolar Disorder and Low Bone Mass: A Cross-Sectional Study With Newly Diagnosed, Drug-Naïve Patients.

作者信息

Li Sujuan, Qui Yan, Teng Ziwei, Chen Jindong, Kang Dongyu, Tang Hui, Xiang Hui, Wu Chujun, Tan Yuxi, Wang Lu, Yang Yanyi, Wang Bolun, Wu Haishan

机构信息

Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, China.

National Clinical Research Center for Mental Disorders, Changsha, China.

出版信息

Front Psychiatry. 2020 Jun 10;11:530. doi: 10.3389/fpsyt.2020.00530. eCollection 2020.

Abstract

BACKGROUND

Medical comorbidities in people with mental disorders have recently gained more attention. People with bipolar disorder (BD) often have comorbid low bone mass, which is associated with increased fracture risk and related severe outcomes. However, few clinical studies on bone metabolism in BD patients are available. This study was designed to assess bone mineral density (BMD) and related influencing factors in a sample of newly diagnosed, drug-naïve individuals with BD and age- and sex-matched healthy controls.

METHODS

Sixty-one drug-naïve individuals with BD (DSM-V) and 95 healthy volunteers had their lumbar spine (L1-L4) and left hip (Neck/Troch/Ward's) BMD determined by dual-energy X-ray absorptiometry. Besides, sociodemographic and clinical assessment were collected. Between-group comparisons and within subgroup analysis were performed.

RESULTS

Drug-naïve patients with BD had significantly lower BMD in comparison to healthy controls in multiple sites (L1, L3, Neck, Troch, Ward's, and total hip). On subgroup analysis, overweight individuals with BD had higher bone mass, while females presented reduced BMD. Binary logistic regression showed that low BMD in multiple regions was associated with BD diagnosis, body mass index (BMI), gender, and age.

CONCLUSION

Drug-naïve individuals with BD have lower BMD when compared to an age- and gender-matched healthy control sample. Low BMI and female gender are factors associated with this outcome. The underlying pathological mechanisms of BD comorbid with osteoporosis should be further explored.

CLINICAL TRIAL REGISTRATION

www.chictr.org.cn, identifier ChiCTR190002137.

摘要

背景

精神障碍患者的医学合并症最近受到了更多关注。双相情感障碍(BD)患者常伴有合并低骨量,这与骨折风险增加及相关严重后果有关。然而,关于BD患者骨代谢的临床研究较少。本研究旨在评估新诊断、未用药的BD患者样本以及年龄和性别匹配的健康对照者的骨密度(BMD)及相关影响因素。

方法

61名未用药的BD(DSM-V)患者和95名健康志愿者通过双能X线吸收法测定了腰椎(L1-L4)和左髋部(颈/转子/沃德三角区)的骨密度。此外,还收集了社会人口学和临床评估信息。进行了组间比较和亚组内分析。

结果

与健康对照者相比,未用药的BD患者在多个部位(L1、L3、颈、转子、沃德三角区和全髋)的骨密度显著降低。亚组分析显示,超重的BD患者骨量较高,而女性的骨密度降低。二元逻辑回归显示,多个区域的低骨密度与BD诊断、体重指数(BMI)、性别和年龄有关。

结论

与年龄和性别匹配的健康对照样本相比,未用药的BD患者骨密度较低。低BMI和女性性别是与这一结果相关的因素。BD合并骨质疏松的潜在病理机制应进一步探索。

临床试验注册

www.chictr.org.cn,标识符ChiCTR190002137。

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