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KMID : 0605720060120020204
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Journal of the Korean Society of Biological Therapies in Psychiatry
2006 Volume.12 No. 2 p.204 ~ p.214
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Correlations between Hyperprolactinemia and Bone Mineral Density, Bone Markers in Women with Chronic Schizophrenia
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Won Seung-Hee
Kwak Kyung-Phil
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Abstract
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Objectives：Osteoporosis is regularly mentioned as a possible consequence of treatment with prolactin raising antipsychotic medications. We investigated the association between schizophrenia and a decrease in bone mineral density(BMD) and to get more insight into potential underlying pathophysiological mechanisms.
Methods：In a cross-sectional study, we screened 36 schizophrenic outpatient women(age 20-45 years) who were treated with same antipsychotics for at least one year. BMD measurements were performed by dual-energy X-ray absorptiometry(DEXA) in the distal forearm, lumbar spine and femoral neck. We also estimated psychopathology, menstrual regularity, body mass index(BMI), daily nutritional status, daily physical activity, hormones and bone marker (osteocalcin, deoxypyridinoline). As the results of prolactin levels, subjects were classified into two groups; prolactin raising group(PR, 16 subjects) and not raising group(No-PR, 12 subjects).
Results：Mean prolactin level in PR was higher than in No-PR and mean cholesterol level in No-PR was higher than in PR significantly. Mean estradiol level was within normal ranges excluding 2 subjects in PR. The proportions of reduced bone mass(osteopenia, osteoporosis) at each sites were 12.5-31.3% in PR and 0.0-25.0% in No-PR. Mean BMD T scores at distal forearm in PR mildly lower than in No-PR( t=-1.968, p=0.06), but those of other sites were not significant differences between two groups. Correlations between prolactin levels and BMD T scores at all sites were not statistically significance. Correlations between the levels of prolactin and bone markers were not significance too. After adjusting for prolactin, BMI and medication period of current antipsychotics variables, statistically significant inverse correlation was observed for cholesterol levels - BMD T scores at the distal forearm.
Conclusion：The present results suggest that hyperprolactinemia induced by long-term neuroleptics may be at high risk of reducing BMD and may be counterbalanced with estradiol incompletely in schizophrenic women. In addition, we noticed that cholesterol may be a risk factor in losing bone mass irrespective of prolactin levels.
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KEYWORD
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Antipsychotics, Prolactin, Cholesterol, Bone mineral density, Bone marker
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