Skip to main content

Advertisement

SpringerLink
Log in

Bone mineral density, quantitative ultrasound parameters and bone metabolism in postmenopausal women with depression

  • IM - ORIGINAL
  • Published:
Internal and Emergency Medicine Aims and scope Submit manuscript

Abstract

Low bone mineral density, which increases the risk of stress fragility fractures, is a frequent, often persistent finding in patients with major depressive disorder (MDD). The clinical association between major depressive disorder and osteopenia is still unclear, although several factors are associated with a loss of bone mass. The aim of our study, therefore, was to evaluate bone mineral density and bone metabolism in patients with MDD. Bone mineral density was evaluated in fifty postmenopausal women with MDD, and in 50 matched postmenopausal control women by dual-energy X-ray absorptiometry of the lumbar spine and femur, and by ultrasonography of the calcaneus and phalanges. Serum levels of 25-hydroxivitamin D, parathyroid hormone, Osteoprotegerin/Receptor Activator for Nuclear Factor κB Ligand ratio, bone turnover markers, serum and urinary cortisol were examined. Bone mineral density of the lumbar spine (BMD: 0.72 ± 0.06 vs. 0.82 ± 0.09 g/cm2, p < 0.001), femoral neck (BMD: 0.58 ± 0.04 vs. 0.71 ± 0.07 g/cm2, p < 0.001) and total femur (BMD 0.66 ± 0.09 vs. 0.54 ± 0.06 g/cm2, p < 0.001); and ultrasound parameters at calcaneus (SI: 81.30 ± 6.10 vs. 93.80 ± 7.10, p < 0.001) and phalanges (AD-SOS: 1915.00 ± 37.70 vs. 2020.88 ± 39.46, p < 0.001; BTT : 1.30 ± 0.8 vs. 1.45 ± 0.9, p < 0.001) are significantly lower in patients with MDD compared with controls. Moreover bone turnover markers, parathyroid hormone levels and Receptor Activator for Nuclear Factor κB Ligand are significantly higher in MDD patients compared with controls, while serum levels of 25-hydroxivitamin D and osteoprotegerin are significantly lower. There are no differences in urinary excretion and serum cortisol between groups. Postmenopausal women with depressive disorder have an elevated risk for osteoporosis. Our data suggest that a high level of parathyroid hormone may play a role in the pathogenetic process underlying osteopenia in these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ross PD (1996) Osteoporosis. Frequency, consequences, and risk factors. Arch Intern Med 156(13):1399–1411

    Article  PubMed  CAS  Google Scholar 

  2. Van Vort WB, Rubenstein M, Rose RP (1990) Osteoporosis with pathological hip fractures in major depression. J Geriatr Psychiatry Neurol 3:10–12

    Article  PubMed  Google Scholar 

  3. Halbreich U, Palter S (1996) Accelerated osteoporosis in psychiatric patients: possible pathophysiologic processes. Schizophr Bull 22:447–454

    Article  PubMed  CAS  Google Scholar 

  4. Cizza G, Ravn P, Chrousos GP, Gold PW (2001) Depression: a major, unrecognized risk factor for osteoporosis. Trends Endocrinol Metab 12:198–203

    Article  PubMed  CAS  Google Scholar 

  5. Varga E, Csaba G, Holló I, Koref O (1968) Androgen deficit and osteoporosis in depressed female patients. Act Nerv Super 10:12–14

    CAS  Google Scholar 

  6. Schweiger U, Deuschle M, Körner A et al (1994) Low lumbar bone mineral density in patients with major depression. Am J Psychiatry 151:1691–1693

    PubMed  CAS  Google Scholar 

  7. Michelson D, Stratakis C, Hill L et al (1996) Bone mineral density in women with depression. N Engl J Med 335:1176–1182

    Article  PubMed  CAS  Google Scholar 

  8. Schweiger U, Weber B, Deuschle M, Heuser I (2000) Lumbar bone mineral density in patients with major depression: evidence of increased bone loss at follow up. Am J Psychiatry 157:118–120

    PubMed  CAS  Google Scholar 

  9. Robbins J, Hirsch C, Whitmer R, Cauley J, Harris T (2001) The association of bone mineral density and depression in an older population. J Am Geriatr Soc 49:732–736

    Article  PubMed  CAS  Google Scholar 

  10. Mussolino ME (2005) Depression and hip fracture risk: the NHANES I epidemiologic follow-up study. Public Health Rep 120:71–75

    PubMed  Google Scholar 

  11. Jacka FN, Pasco JA, Henry MJ et al (2005) Depression and bone mineral density in a community sample of perimenopausal women: Geelong Osteoporosis Study. Menopause 12:88–91

    Article  PubMed  Google Scholar 

  12. Ozsoy S, Eşel E, Turan MT et al (2005) Is there any alteration in bone mineral density in patients with depression? Turk Psikiyatri Derg 16:77–82

    PubMed  Google Scholar 

  13. Reginster JY, Deroisy R, Paul I, Hansenne M, Ansseau M (1999) Depressive vulnerability is not an independent risk factor for osteoporosis in postmenopausal women. Maturitas 33:133–137

    Article  PubMed  CAS  Google Scholar 

  14. Whooley MA, Cauley JA, Zmuda JM, Haney EM, Glynn NW (2004) Depressive symptoms and bone mineral density in older men. J Geriatr Psychiatry Neurol 17:88–92

    Article  PubMed  Google Scholar 

  15. Yazici AE, Bagis S, Tot S, Sahin G, Yazici K, Erdogan C (2005) Bone mineral density in premenopausal women with major depression. Joint Bone Spine 72:540–543

    Article  PubMed  Google Scholar 

  16. Wong SY, Lau EM, Lynn H et al (2005) Depression and bone mineral density: is there a relationship in elderly Asian men? Results from Mr. Os (Hong Kong). Osteoporos Int 16(6):610–615

    Article  PubMed  Google Scholar 

  17. Hofbauer LC, Heufelder AE (2000) The role of receptor activator of nuclear factor- B ligand and osteoprotegerin in the pathogenesis and treatment of metabolic bone diseases. J Clin Endocrinol Metab 85:2355–2363

    Article  PubMed  CAS  Google Scholar 

  18. Simonet WS, Lacey DL, Dunstan CR et al (1997) Osteoprotegerin: a novel secreted protein involved in the regulation of bone density. Cell 89:309–319

    Article  PubMed  CAS  Google Scholar 

  19. Li J, Sarosi I, Yan XQ et al (2000) RANK is the intrinsic hematopoietic cell surface receptor that controls osteoclastogenesis and regulation of bone mass and calcium metabolism. Proc Natl Acad Sci USA 97:1566–1571

    Article  PubMed  CAS  Google Scholar 

  20. Wu Q, Magnus JH, Liu J, Bencaz AF, Hentz JG (2009) Depression and low bone mineral density: a meta-analysis of epidemiologic studies. Osteoporos Int 20(8):1309–1320

    Article  PubMed  CAS  Google Scholar 

  21. Murphy PK, Wagner CL (2008) Vitamin D and mood disorders among women: an integrative review. J Midwifery Womens Health 53(5):440–446

    Article  PubMed  Google Scholar 

  22. Jorde R, Sneve M, Figenschau Y, Svartberg J, Waterloo K (2008) Effects of vitamin D supplementation on symptoms of depression in overweight and obese subjects: randomized double blind trial. J Intern Med Dec 264(6):599–609

    Article  CAS  Google Scholar 

  23. Hollis BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135(2):317–322 Review

    PubMed  CAS  Google Scholar 

  24. Lips P, Duong T, Oleksik A et al (2001) A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcome of raloxifene evaluation clinical trial. J Clin Endocrinol Metab 86(3):1212–1221

    Article  PubMed  CAS  Google Scholar 

  25. Kahl KG, Rudolf S, Dibbelt L et al (2005) Decreased osteoprotegerin and increased bone turnover in young female patients with major depressive disorder and a lifetime history of anorexia nervosa. Osteoporos Int 16(4):424–429

    Article  PubMed  CAS  Google Scholar 

  26. Petronijević M, Petronijević N, Ivković M et al (2008) Low bone mineral density and high bone metabolism turnover in premenopausal women with unipolar depression. Bone 42(3):582–590

    Article  PubMed  Google Scholar 

  27. Lee SK, Lorenzo JA (1999) Parathyroid hormone stimulates TRANCE and inhibits osteoprotegerin messenger ribonucleic acid expression in murine bone marrow cultures: correlation with osteoclast-like cell formation. Endocrinology 140(8):3552–3561

    Article  PubMed  CAS  Google Scholar 

  28. Van Craenenbroeck K, De Bosscher K, Vanden Berghe W, Vanhoenacker P, Haegeman G (2005) Role of glucocorticoids in dopamine-related neuropsychiatric disorders. Mol Cell Endocrinol 1-2:10–22 Review

    Article  Google Scholar 

  29. Pariante CM, Papadopoulos AS, Poon L et al (2002) A novel prednisolone suppression test for the hypothalamic-pituitary-adrenal axis. Biol Psychiatry 51(11):922–930

    Article  PubMed  CAS  Google Scholar 

  30. Minetto M, Reimondo G, Osella G, Ventura M, Angeli A, Terzolo M (2004) Bone loss is more severe in primary adrenal than in pituitary-dependent Cushing’s syndrome. Osteoporos Int 15(11):855–861

    Article  PubMed  CAS  Google Scholar 

  31. Borer KT (2005) Physical activity in the prevention and amelioration of osteoporosis in women: interaction of mechanical, hormonal and dietary factors. Sports Med 35(9):779–830 Review

    Article  PubMed  Google Scholar 

  32. Diem SJ, Blackwell TL, Stone KL et al (2007) Use of antidepressants and rates of hip bone loss in older women: the study of osteoporotic fractures. Arch Intern Med 167(12):1240–1245

    Article  PubMed  Google Scholar 

  33. Haney EM, Chan BK, Diem SJ, Osteoporotic Fractures in Men Study Group et al (2007) Association of low bone mineral density with selective serotonin reuptake inhibitor use by older men. Arch Intern Med 167(12):1246–1251

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Prize of research “Angelo Monteverde” year 2007, Italian Society of Internal Medicine (SIMI).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, University of Messina, Policlinico “G.Martino”, Via C. Valeria 1, 98123, Messina, Italy

    Marco Atteritano, Antonino Lasco, Susanna Mazzaferro, Antonino Catalano, Gianluca Bagnato, Gianfilippo Bagnato & Nicola Frisina

  2. Department of Clinical and Experimental Medicine and Pharmacology, University of Messina, Messina, Italy

    Ida Macrì

  3. Department of Aging, Urological and Neurological Sciences, University of Catania, Catania, Italy

    Antonino Santangelo

Authors
  1. Marco Atteritano
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Antonino Lasco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Susanna Mazzaferro
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ida Macrì
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonino Catalano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Antonino Santangelo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gianluca Bagnato
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gianfilippo Bagnato
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nicola Frisina
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marco Atteritano.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Atteritano, M., Lasco, A., Mazzaferro, S. et al. Bone mineral density, quantitative ultrasound parameters and bone metabolism in postmenopausal women with depression. Intern Emerg Med 8, 485–491 (2013). https://doi.org/10.1007/s11739-011-0628-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11739-011-0628-1

Keywords

Search

Navigation