title: Relationship between long-term use of a typical antipsychotic medication by Chinese schizophrenia patients and the bone turnover markers serum osteocalcin and β-CrossLaps.
abstract: Increasing evidence shows that schizophrenia patients with long-term exposure to antipsychotic medications have decreased bone mass, which suggests that they are at a high risk of osteoporosis. However, the mechanism underlying this remains unclear. In this study, we selected two bone turnover markers to explore whether atypical antipsychotics can affect bone metabolism and identified possible influencing factors.
  
  
  
  A total of 116 schizophrenia patients (18-40years old) participated in the study. The subjects included 31 drug-naive first-episode patients and 85 patients who had undergone atypical antipsychotic monotherapy for at least 6months. A total of 71 subjects were assigned as normal controls. Demographic and physical examination data were analyzed for all subjects. The positive and negative syndrome scale (PANSS) was used to assess psychopathology in schizophrenia patients. Levels of the bone turnover markers osteocalcin and β-CrossLaps were measured. Serum prolactin (PRL), lipid, sex hormone, glucose, insulin, and parathyroid hormone levels were also measured.
  
  
  
  The serum β-CrossLaps levels of patients who had been treated with atypical antipsychotics were higher compared with those of drug-naive first-episode patients and normal subjects. Atypical antipsychotics, schizophrenia, age, gender, and body mass index, as well as serum levels of PRL, triglyceride, high-density lipoprotein cholesterol, glucose, and testosterone, were significantly associated with serum osteocalcin and β-CrossLaps levels. Serum insulin was only positively associated with serum osteocalcin, whereas estradiol was only negatively associated with serum β-CrossLaps.
  
  
  
  Patients who had been treated with atypical antipsychotics had accelerated bone resorption. Our findings uncover a link between atypical antipsychotics and bone metabolism, possibly through abnormalities in glucose and lipid metabolism and insulin resistance.
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Beibei
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Deng
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Haishan
authors.initials: H
authors.lastname: Wu
authors.affiliation: Qingdao Mental Health Center, Qingdao, Shandong, 266034, China.
authors.forename: Xiaozi
authors.initials: X
authors.lastname: Lu
authors.affiliation: Metabolic Endocrinology Institute of the Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China.
authors.forename: Lihong
authors.initials: L
authors.lastname: Peng
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Renrong
authors.initials: R
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Guo
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China. Electronic address: chenjd269@163.com.
authors.forename: Jindong
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Lehua
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Psychiatry, the Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China; Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Center on Mental Disorders (xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.
authors.forename: Jingping
authors.initials: J
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D016723:Bone Remodeling / Q000187:drug effects; D003094:Collagen / Q000097:blood*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D015675:Osteocalcin / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000097:blood* / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D015415:Biomarkers; D010446:Peptide Fragments; C110762:glutamyl-lysyl-alanyl-histidyl-aspartyl-glycyl-glycyl-arginine; D015675:Osteocalcin; D003094:Collagen
keywords: Antipsychotics; Bone turnover; Glucose; Lipid; Osteoporosis; Schizophrenia