Examining depression, antidepressants use, and class and their potential associations with osteoporosis and fractures in adult women: Results from ten NHANES cohorts.

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY Journal of affective disorders Pub Date : 2024-10-28 DOI:10.1016/j.jad.2024.10.114
Humam Emad Rajha, Reem Abdelaal, Khouloud Charfi, Aisha O Alemadi, Alyaa S Al-Sheraim, Mubarak A Al-Maadid, Youssef Louati, Suhail Doi, Salma M Khaled
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Abstract

Introduction: Osteoporosis, a significant public health concern, affects millions of adult women globally, leading to increased morbidity and fracture risk. Antidepressant use, prevalent in this demographic, is suggested to influence bone mineral density (BMD), yet evidence remains limited across antidepressant classes.

Objective/aim: We investigated the association between antidepressant use and osteoporosis in a representative sample of adult women in the United States, focusing on different classes of antidepressants and their potential associations with BMD and fracture risk.

Methods: We conducted a cross-sectional analysis using data from ten cohorts of the National Health and Nutrition Examination Survey (NHANES) spanning 1999-2000 to 2017-2020. The sample included adult women, with data collected on antidepressant use, BMD scores, and reported fractures. Statistical models adjusted for potential confounders such as Major Depressive Disorder (MDD), age, physical activity, and comorbidities.

Results: Antidepressant use was associated with a 44 % increase in the odds of osteoporosis. Phenylpiperazines showed the highest association, followed by miscellaneous antidepressants and tricyclic antidepressants (TCAs). Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) also demonstrated significant, though comparatively lower associations. The odds of fractures were elevated by 62 % among antidepressant users, particularly with phenylpiperazines and miscellaneous antidepressants. A dose-response analysis indicated that both the number and duration of antidepressants were associated with increased odds of osteoporosis.

Conclusion: Our findings underscore the need for heightened awareness of the adverse effects of antidepressants on bone health, particularly in adult women. Careful consideration is necessary when prescribing these medications, especially in populations at risk for osteoporosis and MDD.

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研究抑郁症、抗抑郁药的使用和等级及其与成年女性骨质疏松症和骨折的潜在关联:来自十个 NHANES 队列的结果。
导言:骨质疏松症是一个重大的公共卫生问题,影响着全球数百万成年女性,导致发病率和骨折风险增加。在这一人群中普遍使用的抗抑郁药被认为会影响骨矿物质密度(BMD),但不同类别抗抑郁药的证据仍然有限。目的/意义:我们调查了美国成年女性代表性样本中使用抗抑郁药与骨质疏松症之间的关系,重点研究了不同类别的抗抑郁药及其与 BMD 和骨折风险之间的潜在关系:我们利用美国国家健康与营养调查(NHANES)1999-2000 年至 2017-2020 年期间十个队列的数据进行了横断面分析。样本包括成年女性,收集的数据包括抗抑郁药的使用、BMD评分和报告的骨折情况。统计模型对重度抑郁症(MDD)、年龄、体力活动和合并症等潜在混杂因素进行了调整:结果:使用抗抑郁药导致骨质疏松症的几率增加了 44%。苯基哌嗪类药物的相关性最高,其次是其他抗抑郁药和三环类抗抑郁药(TCAs)。选择性血清素再摄取抑制剂(SSRIs)和血清素-去甲肾上腺素再摄取抑制剂(SNRIs)也显示出显著的相关性,但相对较低。使用抗抑郁药的人发生骨折的几率增加了 62%,尤其是使用苯丙哌嗪类和其他抗抑郁药的人。抗抑郁药使用时间的延长与骨质疏松症和骨折风险的升高密切相关,与抗抑郁药的类别无关:我们的研究结果表明,有必要提高对抗抑郁药对骨骼健康不利影响的认识,尤其是对成年女性。在开具此类药物处方时,尤其是在骨质疏松症和多发性硬化症的高危人群中,必须慎重考虑。
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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