Williams Lana J, Quirk Shae E, Koivumaa-Honkanen Heli, Honkanen Risto, Pasco Julie A, Stuart Amanda L, Kavanagh Bianca E, Heikkinen Jeremi, Berk Michael
Deakin University, Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, VIC, Australia.
University Hospital Geelong, Barwon Health, Geelong, VIC, Australia.
Front Psychiatry. 2020 Dec 8;11:602342. doi: 10.3389/fpsyt.2020.602342. eCollection 2020.
We examined whether personality disorders (PDs) (any, cluster A/B/C) were associated with bone mineral density (BMD) in a population-based sample of Australian women ( = 696). Personality and mood disorders were assessed using semi-structured diagnostic interviews. BMD was measured at the spine, hip, and total body using dual-energy x-ray absorptiometry (GE-Lunar Prodigy). Anthropometrics, medication use, physical conditions, and lifestyle factors were documented. The association between PDs (any, cluster A/B/C) and BMD (spine/hip/total body) was examined with multiple linear regression models. The best models were identified by backward elimination including age, weight, physical activity, smoking status, alcohol consumption, dietary calcium intake, mood disorders, physical multimorbidity, socioeconomic status, and medications affecting bone. The variables were retained in the model if < 0.05. All potential interactions in final models were tested. Those with cluster A PD, compared to those without, had 6.7% lower hip BMD [age, weight adjusted mean 0.853 (95% CI 0.803-0.903) vs. 0.910 (95% CI 0.901-0.919) g/cm, = 0.027] and 3.4% lower total body BMD [age, weight, smoking, alcohol, calcium adjusted mean 1.102 (95% CI 1.064-1.140) vs. 1.139 (95% CI 1.128-1.150) g/cm, = 0.056]. No associations were observed between cluster B/C PDs and hip/total body BMD or between any of the PD clusters and spine BMD. To our knowledge, this study is the first to investigate the bone health of women with PD in a population-based sample. Given the paucity of literature, replication and longitudinal research including the examination of underlying mechanisms and sex differences are warranted.
我们在一个基于人群的澳大利亚女性样本（n = 696）中，研究了人格障碍（任何类型、A/B/C簇）是否与骨密度（BMD）相关。使用半结构化诊断访谈评估人格和情绪障碍。使用双能X线吸收法（GE-Lunar Prodigy）测量脊柱、髋部和全身的骨密度。记录人体测量学、药物使用、身体状况和生活方式因素。使用多元线性回归模型研究人格障碍（任何类型、A/B/C簇）与骨密度（脊柱/髋部/全身）之间的关联。通过向后排除法确定最佳模型，纳入年龄、体重、身体活动、吸烟状况、饮酒量、膳食钙摄入量、情绪障碍、身体多种疾病、社会经济地位以及影响骨骼的药物等因素。如果p < 0.05，则将变量保留在模型中。对最终模型中的所有潜在交互作用进行了检验。与没有A簇人格障碍的女性相比，患有A簇人格障碍的女性髋部骨密度低6.7%[年龄、体重调整后均值0.853（95%CI 0.803 - 0.903）g/cm² 对比 0.910（95%CI 0.901 - 0.919）g/cm²，p = 0.027]，全身骨密度低3.4%[年龄、体重、吸烟、饮酒、钙调整后均值1.102（95%CI 1.064 - 1.140）g/cm² 对比 1.139（95%CI 1.128 - 1.150）g/cm²，p = 0.056]。未观察到B/C簇人格障碍与髋部/全身骨密度之间存在关联，也未观察到任何人格障碍簇与脊柱骨密度之间存在关联。据我们所知，本研究是首次在基于人群的样本中调查患有人格障碍的女性的骨骼健康状况。鉴于相关文献较少，有必要进行重复研究和纵向研究，包括对潜在机制和性别差异的研究。
