title: Sex-specific factors for bone density in patients with schizophrenia.
abstract: Patients with schizophrenia are susceptible to low bone mineral density (BMD). Many risk factors have been suggested. However, it remains uncertain whether the risk factors differ between men and women. In addition, the study of bone density in men is neglected more often than that in women. This study aims to examine specific risk factors of low BMD in different sexes. Men (n=80) and women (n=115) with schizophrenia, similar in demographic and clinical characteristics, were enrolled in three centers. Clinical and laboratory variables (including blood levels of prolactin, sex and thyroid hormones, cortisol, calcium, and alkaline phosphatase) were collected. BMD was measured using a dual-energy X-ray absorptiometer. Men had lower BMD than women. Predictors for BMD in men included hyperprolactinemia (B=-0.821, P=0.009), body weight (B=0.024, P=0.046), and Global Assessment of Functioning score (B=0.027, P=0.043); in women, BMD was associated with menopause (B=-1.070, P<0.001), body weight (B=0.027, P=0.003), and positive symptoms (B=0.094, P<0.001). In terms of the effect of psychotic symptoms, positive symptoms were related positively to BMD in women, but not in men. The findings suggest that sex-specific risk factors should be considered for an individualized intervention of bone loss in patients with schizophrenia. Physicians should pay particular attention to bone density in men with hyperprolactinemia and postmenopausal women. Further prospective studies in other populations are warranted to confirm these findings.
authors.affiliation: aDepartment of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung bInstitute of Clinical Medical Science, China Medical University cDepartment of Psychiatry, China Medical University Hospital, Taichung dDepartment of Psychiatry, Changhua Hospital eDepartment of Physical Education, National Changhua University of Education, Changhua fDepartment of Mathematics, Tamkang University, Taipei, Taiwan.
authors.forename: Chieh-Hsin
authors.initials: CH
authors.lastname: Lin
authors.forename: Chun-Yuan
authors.initials: CY
authors.lastname: Lin
authors.forename: Tiao-Lai
authors.initials: TL
authors.lastname: Huang
authors.forename: Hong-Song
authors.initials: HS
authors.lastname: Wang
authors.forename: Yue-Cune
authors.initials: YC
authors.lastname: Chang
authors.forename: Hsien-Yuan
authors.initials: HY
authors.lastname: Lane
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D014150:Antipsychotic Agents / Q000494:pharmacology; D015519:Bone Density / Q000187:drug effects; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D011388:Prolactin / Q000097:blood; D012307:Risk Factors; D012559:Schizophrenia / Q000097:blood / Q000378:metabolism*; D012727:Sex Characteristics; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D011388:Prolactin; D000469:Alkaline Phosphatase; D002118:Calcium; D006854:Hydrocortisone