Abstract
BackgroundMedical comorbidities in people with mental disorders have recently gained more attention. People with bipolar disorder (BD) often have comorbid low bone mass, which is associated with increased fracture risk and related severe outcomes. However, few clinical studies on bone metabolism in BD patients are available. This study was designed to assess bone mineral density (BMD) and related influencing factors in a sample of newly diagnosed, drug-naïve individuals with BD and age- and sex-matched healthy controls.MethodsSixty-one drug-naïve individuals with BD (DSM-V) and 95 healthy volunteers had their lumbar spine (L1–L4) and left hip (Neck/Troch/Ward's) BMD determined by dual-energy X-ray absorptiometry. Besides, sociodemographic and clinical assessment were collected. Between-group comparisons and within subgroup analysis were performed.ResultsDrug-naïve patients with BD had significantly lower BMD in comparison to healthy controls in multiple sites (L1, L3, Neck, Troch, Ward's, and total hip). On subgroup analysis, overweight individuals with BD had higher bone mass, while females presented reduced BMD. Binary logistic regression showed that low BMD in multiple regions was associated with BD diagnosis, body mass index (BMI), gender, and age.ConclusionDrug-naïve individuals with BD have lower BMD when compared to an age- and gender-matched healthy control sample. Low BMI and female gender are factors associated with this outcome. The underlying pathological mechanisms of BD comorbid with osteoporosis should be further explored.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR190002137.
Highlights
Bipolar disorder (BD) is a chronic mental illness characterized by recurrent manic and depressive episodes that manifest throughout the lifespan, usually starting during adolescence or early adulthood [1]
Drug-naïve individuals with BD have lower bone mineral density (BMD) when compared to an ageand gender-matched healthy control sample
Low body mass index (BMI) and female gender are factors associated with this outcome
Summary
Bipolar disorder (BD) is a chronic mental illness characterized by recurrent manic (or hypomanic) and depressive episodes that manifest throughout the lifespan, usually starting during adolescence or early adulthood [1] It is a highly incident and frequent condition, with estimated lifetime prevalence of 0.81– 1.29% and no gender, race, or ethnic predilection [2]. Typical mood shifts during BD exacerbations can negatively influence individual functionality, significant impairment may take place in-between depressive or manic episodes [3] During these periods, comorbid medical conditions lead to declined quality of life, prolonged and complex treatment cycles, and higher mortality. People with bipolar disorder (BD) often have comorbid low bone mass, which is associated with increased fracture risk and related severe outcomes. This study was designed to assess bone mineral density (BMD) and related influencing factors in a sample of newly diagnosed, drug-naïve individuals with BD and age- and sex-matched healthy controls
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