Second-generation antipsychotics and bone turnover in schizophrenia.

Abstract

Accumulating evidence suggests that patients with schizophrenia are exposed to a high risk of osteoporosis/osteopenia caused by long-term antipsychotic treatment. The degree of bone mineral density (BMD) loss that a given antipsychotic may cause is not known. Examinations using a bone turnover marker may more accurately predict the ongoing bone states in psychiatric patients. We measured prolactin, estradiol, testosterone, and bone resorption marker (TRACP-5b) levels in 167 patients with schizophrenia and 60 normal controls. The patients showed significantly higher levels of prolactin and lower levels of TRACP-5b compared to the controls. Moreover, prolactin was negatively correlated with estradiol and testosterone in the group of all male subjects and the male patients. TRACP-5b was positively correlated with prolactin in the female patients and negatively correlated with estradiol in the group of all female subjects. The results show that the bone resorption rate was rather attenuated in the patients compared to the normal controls, suggesting a complicated etiology of BMD loss in schizophrenia patients. Several meaningful correlations between key factors in this study confirmed that hyperprolactinemia induced the suppression of sex hormones, and possibly led to the higher bone turnover. These results indicate that measurement of the resorption marker TRACP-5b might be useful to clarify the pathology of BMD loss.

• Authors: Kyoji Okita, Nobuhisa Kanahara, Motoi Nishimura, Toshihiko Yoshida, Norio Yasui-Furukori, Tomihisa Niitsu, Taisuke Yoshida, Masatomo Ishikawa, Hiroshi Kimura, Fumio Nomura, Masaomi Iyo
• Journal: Schizophrenia research (Schizophr Res) Vol. 157 Issue 1-3 Pg. 137-41 (Aug 2014) ISSN: 1573-2509 [Electronic] Netherlands
• PMID: 24888527 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier B.V. All rights reserved.

Chemical References

• Antipsychotic Agents
• Biomarkers
• Isoenzymes
• Testosterone
• Estradiol
• Prolactin
• ACP5 protein, human
• Acid Phosphatase
• Tartrate-Resistant Acid Phosphatase

Topics

• Acid Phosphatase (blood)
• Adult
• Antipsychotic Agents (adverse effects, therapeutic use)
• Biomarkers (blood)
• Bone Density (drug effects)
• Bone Resorption (blood, chemically induced)
• Estradiol (blood)
• Female
• Humans
• Hyperprolactinemia (blood, chemically induced)
• Isoenzymes (blood)
• Male
• Prolactin (blood)
• Schizophrenia (blood, drug therapy)
• Sex Factors
• Tartrate-Resistant Acid Phosphatase
• Testosterone (blood)