Lana J. Williams, Bruno Agustini, Amanda L. Stuart, Julie A. Pasco, Jason M. Hodge, Rasika M. Samarasinghe, Ottar Bjerkeset, Shae E. Quirk, Heli Koivumaa-Honkanen, Risto Honkanen, Jeremi Heikkinen, Michael Berk
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引用次数: 0
摘要
简介几种精神障碍和用于治疗精神障碍的药物似乎都与骨骼缺陷有关。有越来越多的证据表明,锂具有保护骨骼的作用,因此,我们旨在研究锂的使用与双相情感障碍女性患者的骨骼健康之间的关系:方法:我们从澳大利亚东南部招募了患有躁郁症的女性(n = 117,20 岁以上)。通过临床访谈(SCID-I/NP)确认双相情感障碍。使用双能 X 射线吸收测量法测量了脊柱、髋部和全身的骨密度(BMD;克/平方厘米),并根据 BMD T 评分确定了低骨量结果:35名(29.9%)女性报告目前使用锂。锂使用者和非锂使用者在社会经济地位和 BMD 方面存在差异;除此之外,各组情况相似。经调整后,锂使用者脊柱的平均 BMD 高 5.1%(1.275 [95% CI 1.229-1.321] vs. 1.214 [1.183-1.244] g/cm2,p = 0.03),全髋的平均 BMD 高 4.2%(0.979 [0.942-1.016] vs. 0.938 [0.910-0.966] g/cm2,p = 0.03),全身(1.176 [1.148-1.205] vs. 1.150 [1.129-1.171] g/cm2,p = 0.08)比未服用锂的参与者高出 2.2%。此外,锂使用者的骨量较低(22.9% vs. 43.9%,p = 0.031)。在对混杂因素进行调整后,相关性依然存在:这些数据表明,锂与双相情感障碍女性患者更高的骨密度和更低的骨量风险有关。有必要对其潜在机制进行研究。
Lithium use and bone health in women with bipolar disorder: A cross-sectional study
Introduction
Several psychiatric disorders and medications used to treat them appear to be independently associated with skeletal deficits. As there is increasing evidence that lithium possesses skeletal protective properties, we aimed to investigate the association between lithium use and bone health in a group of women with bipolar disorder.
Method
Women with bipolar disorder (n = 117, 20+ years) were recruited from south-eastern Australia. Bipolar disorder was confirmed using a clinical interview (SCID-I/NP). Bone mineral density (BMD; g/cm2) was measured at the spine, hip and total body using dual-energy x-ray absorptiometry and low bone mass determined by BMD T-score of <−1.0. Weight and height were measured, socioeconomic status (SES) determined and information on medication use and lifestyle factors self-reported. Linear and logistic regression were used to test associations between lithium and (i) BMD and (ii) low bone mass, respectively.
Results
Thirty-five (29.9%) women reported current lithium use. Lithium users and non-users differed in regard to SES and BMD; otherwise, groups were similar. After adjustments, mean BMD among lithium users was 5.1% greater at the spine (1.275 [95% CI 1.229–1.321] vs. 1.214 [1.183–1.244] g/cm2, p = 0.03), 4.2% greater at the total hip (0.979 [0.942–1.016] vs. 0.938 [0.910–0.966] g/cm2, p = 0.03) and 2.2% greater at the total body (1.176 [1.148–1.205] vs. 1.150 [1.129–1.171] g/cm2, p = 0.08) compared to participants not receiving lithium. Lithium users were also less likely to have low bone mass (22.9% vs. 43.9%, p = 0.031). Associations persisted after adjustment for confounders.
Conclusion
These data suggest lithium is associated with greater BMD and reduced risk of low bone mass in women with bipolar disorder. Research into the underlying mechanisms is warranted.
期刊介绍:
Acta Psychiatrica Scandinavica acts as an international forum for the dissemination of information advancing the science and practice of psychiatry. In particular we focus on communicating frontline research to clinical psychiatrists and psychiatric researchers.
Acta Psychiatrica Scandinavica has traditionally been and remains a journal focusing predominantly on clinical psychiatry, but translational psychiatry is a topic of growing importance to our readers. Therefore, the journal welcomes submission of manuscripts based on both clinical- and more translational (e.g. preclinical and epidemiological) research. When preparing manuscripts based on translational studies for submission to Acta Psychiatrica Scandinavica, the authors should place emphasis on the clinical significance of the research question and the findings. Manuscripts based solely on preclinical research (e.g. animal models) are normally not considered for publication in the Journal.