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Depression and Low Bone Mass

Depressed women had lower BMD and higher levels of several proinflammatory markers.

Depression is associated with several physiologic alterations, including a hyperadrenergic state, hypercortisolemia, and an increase in inflammatory cytokines. In turn, each of these alterations may contribute to bone loss. In a cross-sectional study, bone-mineral density (BMD) was assessed among 89 premenopausal women with current or recent major depressive disorder and among 44 premenopausal women without depression.

In the depression group, 82% of the women were receiving antidepressant medication. After adjustment for body-mass index, BMD was significantly lower (by approximately 2%) in depressed women than in controls; the prevalence of low BMD (T score, <–1 at the hip, spine, or both) was greater among women with depression (28% vs. 11%). In addition, levels of several proinflammatory markers, including interleukin (IL)-1β, IL-2, IL-6, and tumor necrosis factor , were measured in a subgroup of participants and found to be substantially higher among the depression group. No significant differences in bone density were noted between users of selective serotonin reuptake inhibitors (SSRIs) and users of non-SSRI medications.

Comment: In this cross-sectional study, depressed premenopausal women had greater risk for low BMD than premenopausal women without depression. This finding, if confirmed in prospective trials, should trigger earlier BMD screening among depressed women.

— Jamaluddin Moloo, MD, MPH

Published in Journal Watch General Medicine December 18, 2007

Citation(s):

Eskandari F et al. Low bone mass in premenopausal women with depression. Arch Intern Med 2007 Nov 26; 167:2329.

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