Bone density characteristics and major depressive disorder in adolescents.
OBJECTIVE
Major depressive disorder (MDD) is common during adolescence, a period characterized by rapid bone mineral accrual. MDD has recently been associated with lower bone mineral density (BMD) in adults. Our objective was to determine whether MDD is associated with BMD, bone turnover markers, vitamin D, and gonadal steroids in adolescents.


METHODS
Sixty-five adolescents 12 to 18 years of age (32 boys: 16 with MDD and 16 controls; 33 girls: 17 with MDD and 16 controls) were included in a cross-sectional study. BMD and body composition were obtained by dual-energy x-ray absorptiometry. Estradiol, testosterone, 25-hydroxy vitamin D levels, N-terminal propeptide of Type 1 procollagen (a marker of bone formation), and Type I collagen C-telopeptide (a marker of bone resorption) were measured.


RESULTS
Boys with MDD had a significantly lower BMD at the hip (mean [standard deviation]=0.99 [0.17] g/cm2 versus 1.04 [0.18] g/cm2, body mass index [BMI] adjusted, p=.005) and femoral neck (0.92 [0.17] g/cm2 versus 0.94 [0.17] g/cm2; BMI adjusted, p=.024) compared with healthy controls after adjusting for BMI. This significant finding was maintained after also adjusting for lean mass and bone age (hip: p=.007; femoral neck: p=.020). In girls, there were no significant differences in BMD between the girls with MDD and the controls after adjusting for BMI (p>.17).


CONCLUSIONS
Male adolescents with MDD have a significantly lower BMD as compared with healthy controls after adjusting for body mass and maturity. This association is not observed in girls.
Neuroendocrine Unit, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, BUL 457, 55 Fruit St, Boston, MA 02114, USA.
Pouneh K
PK
Fazeli
Nara
N
Mendes
Melissa
M
Russell
David B
DB
Herzog
Anne
A
Klibanski
Madhusmita
M
Misra
D015502:Absorptiometry, Photon; D000293:Adolescent; D041923:Adolescent Development / Q000502:physiology; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D001823:Body Composition / Q000502:physiology; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D016723:Bone Remodeling / Q000502:physiology*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000502:physiology*; D016022:Case-Control Studies; D002648:Child; D024042:Collagen Type I / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D012739:Gonadal Steroid Hormones / Q000378:metabolism; D006801:Humans; D008163:Luminescent Measurements; D008297:Male; D011347:Procollagen; D011569:Psychiatric Status Rating Scales; D012727:Sex Characteristics; D017678:Sex Distribution; D014807:Vitamin D / Q000378:metabolism; D055815:Young Adult
D015415:Biomarkers; D024042:Collagen Type I; D012739:Gonadal Steroid Hormones; D011347:Procollagen; D014807:Vitamin D