重度抑郁诱导的内分泌调节是绝经前妇女低骨密度的危险因素

P. Pahari, Vinita Ailani, J. Bhattacharya, Ritwik Ganguli
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摘要

背景:人们开始认识到心理抑郁的显著生理效应会加剧常见疾病,包括骨质疏松症。这篇综述讨论了目前关于心理抑郁相关的精神健康障碍作为骨质疏松症危险因素的证据,可能与这些疾病相关的机制,以及对治疗的潜在影响。骨质疏松症是一个主要的公共卫生威胁,抑郁症是2020年全球第二大致残原因。一些研究报告了抑郁症和低骨矿物质密度之间的联系,但这两种情况之间的因果关系存在争议。我们认为抑郁症诱发绝经前妇女早期骨质流失,主要是通过与特定内分泌机制相关的不良生活习惯促成的。目的:探讨绝经前妇女抑郁、血清皮质醇、维生素D、甲状腺功能减退和骨密度的临床相关性。探讨绝经前妇女继发性骨质疏松症的一个新的危险因素。方法:研究对象为80例骨质疏松症女性患者,年龄30 ~ 60岁。采用hamd量表对抑郁状态进行分析。采用dexa和化学发光法(ELISA)测定骨密度和内分泌参数。采用spss22软件进行统计相关分析。结果:HAM-D评分与血清皮质醇呈极显著相关(P <0.00001)。HAM-D与BMD的相关性也有统计学意义(P <0.05)。骨密度与血清皮质醇(P?0.05)。血清维生素D与BMD的相关性(P<0.00001)远高于与TSH的相关性(P<0.0001)。讨论与结论:高抑郁水平与低维生素D水平或高血清皮质醇和促甲状腺激素水平相关这是绝经前妇女低骨密度发生继发性骨质疏松症的危险因素可以得出结论,无论具体原因如何,抑郁症患者都应考虑进行骨密度筛查,反之亦然。低骨密度的受试者应考虑在生命早期筛查抑郁症,绝经前妇女应在定期体育活动中补充维生素D,以预防继发性骨质疏松症。
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Major Depression Induced Endocrine Modulation is a Risk Factor for Low bone Mineral Density in Premenopausal Women
Background: The significant physiological effects of psychological depression are beginning to berecognized as exacerbating common diseases, including osteoporosis. This review discusses the currentevidence for psychological depression-associated mental health disorders as risk factors for osteoporosis,the mechanisms that may link these conditions, and potential implications for treatmentOsteoporosis is a major public health threat and depression is second most important cause of disabilityworldwide in 2020. Several studies have reported an association between depression and low bone mineraldensity, but a causal link between these two conditions is disputed.We propose that depression induces earlybone loss in premenopausal women, primarily via specific endocrine mechanisms associated poor lifestylehabits contributory.Aim and Objectives: To find the clinical correlation between depression, serum cortisol, vitamin D,hypothyroidism and BMD in Premenopausal Women.To find out a new risk factor of secondary osteoporosis in premenopausal women.Methods: The study group consisted of 80 osteoporotic female patient’s age range between 30-60years.Thestate of depression was analyzed by using Ham D scale. BMD and endocrine parameters was measured byDEXA and chemiluminisence,ELISA. Statistical correlation analyzed by SPSS22software.Results: A highly significant (P <0.00001) correlation was observedbetween HAM-D score and serumcortisol. The correlation between HAM-D and BMD was also significant (P <0.05).No significant correlationwas found between BMD and serum cortisol (P? 0.05).The correlation of serum vitamin D with BMD wasfar more significant (P<0.00001) compared to the association with TSH (P<0.0001).Discussion & Conclusion: A high score of depression associated with low vitamin D level or high serumcortisol and TSH level which is a risk factor for low BMD in premenopausal women to develop secondaryosteoporosisIt can be concluded that Irrespective of the specific causes, subjects with depression should be consideredfor screening for bone mineral density and, vice versa, subjects with low BMD should be considered forscreening for depression in early stage of life and supplementation of vitamin D with regular physicalactivity in premenopausal women for prevention of secondary osteoporosis.
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