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Background: Schizophrenia has been shown to be associated with reduced bone mineral density (BMD) and higher fracture risk. However, less is known whether antipsychotic treatment is associated with reduced BMD. Thus, we aimed to examine associations between antipsychotic use and BMD among men and women drawn from the general population. Methods: This cross-sectional study involved 793 women and 587 men enrolled in the Geelong Osteoporosis Study (GOS). BMD was determined using dual-energy X-ray absorptiometry at the spine and hip. Information regarding socio-economic status (SES), current medication and/or supplementation use, lifestyle factors, and anthropometry was collected. Association between antipsychotic use and BMD was determined using linear regression after adjusting for potential confounders. Results: Of the group, 33 women (4.2%) and 16 men (2.7%) currently used antipsychotics. Age was identified as an effect modifier in the association between antipsychotic use and BMD for women. Amongst women aged < 60 years, adjusted mean BMD was 11.1% lower at the spine [1.139 (95%CI 1.063-1.216) vs. 1.250 (95%CI 1.223-1.277) g/cm2, p = 0.005] for antipsychotic users compared to non-users. At the hip, age, weight, and smoking adjusted mean BMD was 9.9% lower [0.893 (95%CI 0.837-0.950) vs. 0.992 (95%CI 0.976-1.007) g/cm2, p < 0.001] for antipsychotic users in comparison with non-users. The pattern persisted following further adjustments. There was no association detected between antipsychotic use and BMD for women aged 60 years and over and for men. Conclusion: Our data suggest that antipsychotic medication use is associated with reduced BMD in younger women but not older women or men. [ABSTRACT FROM AUTHOR]

BackgroundSchizophrenia has been shown to be associated with reduced bone mineral density (BMD) and higher fracture risk. However, less is known whether antipsychotic treatment is associated with reduced BMD. Thus, we aimed to examine associations between antipsychotic use and BMD among men and women drawn from the general population.MethodsThis cross-sectional study involved 793 women and 587 men enrolled in the Geelong Osteoporosis Study (GOS). BMD was determined using dual-energy X-ray absorptiometry at the spine and hip. Information regarding socio-economic status (SES), current medication and/or supplementation use, lifestyle factors, and anthropometry was collected. Association between antipsychotic use and BMD was determined using linear regression after adjusting for potential confounders.ResultsOf the group, 33 women (4.2%) and 16 men (2.7%) currently used antipsychotics. Age was identified as an effect modifier in the association between antipsychotic use and BMD for women. Amongst women aged < 60 years, adjusted mean BMD was 11.1% lower at the spine [1.139 (95%CI 1.063–1.216) vs. 1.250 (95%CI 1.223–1.277) g/cm2, p = 0.005] for antipsychotic users compared to non-users. At the hip, age, weight, and smoking adjusted mean BMD was 9.9% lower [0.893 (95%CI 0.837–0.950) vs. 0.992 (95%CI 0.976–1.007) g/cm2, p < 0.001] for antipsychotic users in comparison with non-users. The pattern persisted following further adjustments. There was no association detected between antipsychotic use and BMD for women aged 60 years and over and for men.ConclusionOur data suggest that antipsychotic medication use is associated with reduced BMD in younger women but not older women or men.

Abstract Dual-energy x-ray absorptiometry (DXA) can provide quantitative (bone mineral density, BMD) and qualitative (trabecular bone score, TBS) indexes of bone status, able to predict fragility fractures in most osteoporotic patients. A new qualitative index of bone strength, based on finite element analysis and named bone strain index (BSI), has been recently developed from lumbar DXA scan. We present the preliminary results about the BSI ability to predict a refracture in patients with fragility fractures. A total of 143 consecutive fractured patients with primary osteoporosis (121 females) performed a spine x-ray examination for the calculation of spine deformity index (SDI) and a DXA densitometry for BMD, TBS, and BSI at basal time and in the follow-up. A refracture was considered as a one-unit increase in SDI. For each unit increase of the investigated indexes, the hazard ratio of refracture, 95% confidence interval, p value, and proportionality test p value were for BSI 1.201, 0.982−1.468, 0.074, and 0.218; for lumbar BMD 0.231, 0.028−1.877, 0.170, and 0.305; and for TBS 0.034, 0.001−2.579, 0.126, and 0.518, respectively. BSI was the index predictive of refracture nearest to statistical significance. If confirmed, it may be used for a better risk assessment of osteoporotic patients.

Dual-energy x-ray absorptiometry (DXA) can provide quantitative (bone mineral density, BMD) and qualitative (trabecular bone score, TBS) indexes of bone status, able to predict fragility fractures in most osteoporotic patients. A new qualitative index of bone strength, based on finite element analysis and named bone strain index (BSI), has been recently developed from lumbar DXA scan. We present the preliminary results about the BSI ability to predict a refracture in patients with fragility fractures. A total of 143 consecutive fractured patients with primary osteoporosis (121 females) performed a spine x-ray examination for the calculation of spine deformity index (SDI) and a DXA densitometry for BMD, TBS, and BSI at basal time and in the follow-up. A refracture was considered as a one-unit increase in SDI. For each unit increase of the investigated indexes, the hazard ratio of refracture, 95% confidence interval, p value, and proportionality test p value were for BSI 1.201, 0.982−1.468, 0.074, and 0.218; for lumbar BMD 0.231, 0.028−1.877, 0.170, and 0.305; and for TBS 0.034, 0.001−2.579, 0.126, and 0.518, respectively. BSI was the index predictive of refracture nearest to statistical significance. If confirmed, it may be used for a better risk assessment of osteoporotic patients. [ABSTRACT FROM AUTHOR]