title: Lower Bone Mineral Density at the Hip and Lumbar Spine in People with Psychosis Versus Controls: a Comprehensive Review and Skeletal Site-Specific Meta-analysis.
abstract: It remains unclear if differences in bone mineral density (BMD) exist at different skeletal sites between people with schizophrenia and age- and sex-matched healthy controls (HCs). Major databases were searched from inception until February 2016 for studies measuring BMD using dual-energy X-ray absorptiometry (DXA) at any skeletal site in individuals with schizophrenia. Ten studies investigating 827 people with schizophrenia (55.4 % female, 33.8 ± 9.7 years) and 1379 HCs (58.7 % female, 34.7 ± 9.1 years) were included. People with schizophrenia had significantly reduced BMD at the lumbar spine (standardised mean difference adjusted for publication bias (SMD) = -0.950 (95 % CI = -1.23 to -0.66, fail-safe number = 825) and hip (SMD = -0.534, 95 % CI = -0.876 to -0.192, fail-safe number = 186). A higher proportion of hyperprolactinaemia (β = -0.0102, p < 0.0001) and smokers (β = -0.0099, p = 0.02) moderated a larger reduced BMD at the lumbar spine. Further research is required to investigate if low bone mass and fractures can be prevented in people with schizophrenia.
authors.affiliation: Kings College London School of Medical Education, Strand, London, WC2R 2LS, UK.
authors.forename: Lucia
authors.initials: L
authors.lastname: Gomez
authors.affiliation: Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, UK. brendon.stubbs@kcl.ac.uk.|Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK. brendon.stubbs@kcl.ac.uk.
authors.forename: Brendon
authors.initials: B
authors.lastname: Stubbs
authors.affiliation: Kings College London School of Medical Education, Strand, London, WC2R 2LS, UK.
authors.forename: Ayala
authors.initials: A
authors.lastname: Shirazi
authors.affiliation: Department of Rehabilitation Sciences, KU Leuven-University of Leuven, Leuven, Belgium.|University Psychiatric Centre KU Leuven, KU Leuven-University of Leuven, Leuven-Kortenberg, Belgium.
authors.forename: Davy
authors.initials: D
authors.lastname: Vancampfort
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.|National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, BR3 3BX, UK.
authors.forename: Fiona
authors.initials: F
authors.lastname: Gaughran
authors.affiliation: Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.|National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, BR3 3BX, UK.|Department of Psychiatry, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Lally
mesh_terms: D015502:Absorptiometry, Photon; D014150:Antipsychotic Agents / Q000627:therapeutic use; D015519:Bone Density; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D006966:Hyperprolactinemia / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000453:epidemiology*; D012559:Schizophrenia / Q000188:drug therapy / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology
chemical_list: D014150:Antipsychotic Agents
keywords: Bone mineral density; Fracture; Osteoporosis; Psychosis; Schizophrenia