title: Bone mineral density and bone metabolism in patients with major depressive disorder without somatic comorbidities.
abstract: BACKGROUND
  Major depressive disorder (MDD) has been linked with accelerated bone loss leading to the development of low bone mineral density (BMD). Several mechanisms have been discussed as causative factors, e.g. lifestyle, selective serotonin reuptake inhibitor (SSRI) intake, or the influence of proinflammatory cytokines.
  
  
  METHODS
  In a cross-sectional study of in-patients with a current episode of MDD, without somatic comorbidities, we determined various parameters of bone metabolism, inflammatory parameters and parameters of depression. BMD was measured by dual x-ray absorptiometry.
  
  
  RESULTS
  Of 50 patients, only one had low BMD in any of the measure sites. Body mass index (BMI) correlated positively with Z-scores. 83.3% of the examined patients had elevated osteoprotegerin (OPG) levels. SSRI intake did not have an effect on BMD. BMD in the femoral neck was significantly lower in smokers. We also found a positive correlation between the level of physical activity and osteocalcin levels.
  
  
  CONCLUSIONS
  In our sample, young to middle-aged, somatically healthy, and acutely depressed patients with a history of MDD showed no reduction of BMD. This could be due to compensatory mechanisms, as suggested by elevated OPG levels. Physical activity and high BMI could also have served as protective factors. Still, as patients with MDD often suffer from comorbidities or take medication with a negative effect on bone, this population should be appreciated as a high-risk group for the development of osteopenia and osteoporosis.
authors: Department of Biological Psychiatry, Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Peter.Malik@i-med.ac.at
authors: P
authors: P
authors: Malik
authors: R W
authors: RW
authors: Gasser
authors: R C
authors: RC
authors: Moncayo
authors: C
authors: C
authors: Kandler
authors: P
authors: P
authors: Koudouovoh-Tripp
authors: J
authors: J
authors: Giesinger
authors: B
authors: B
authors: Sperner-Unterweger
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000378:metabolism*; D016207:Cytokines / Q000378:metabolism; D003865:Major Depressive Disorder / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008659:Metabolic Diseases / Q000473:pathology*; D008875:Middle Aged; D053244:Osteoprotegerin / Q000378:metabolism; D055815:Young Adult
chemical_list: D016207:Cytokines; D053244:Osteoprotegerin