Abstract
Major depressive disorder (MDD) is considered as a risk factor for osteoporosis. Bone mineral density (BMD), as the main tool for diagnosing osteoporosis, has been reported to have correlation with MDD in different cohorts. However, the information in causative link and etiology determinants of osteoporosis in MDD is still under investigation. The results are unclear. Thus, we perform a meta‐analysis to evaluate the association between altered BMD and MDD. We searched the electronic databases to find studies examining BMD in patients with MDD. Finally, 26 published studies were included in our meta‐analysis up from January 1990 to January 2019. All the data were pooled analysis using RevMan software. The association between altered BMD and MDD was assessed by std. mean difference (STD) and their 95% confidence intervals (CIs) for each study. Twenty‐six studies were included in this meta‐analysis. Pooled results showed a significant lower BMD in spine (STD=0.51, 95% CI=0.30–0.71, p < .00001), total hip (STD=0.41, 95% CI=0.16 to 0.66, p = .001), and femoral neck (STD=0.93, 95% CI=0.32 to 1.55, p = .003) in MDD compared with controls. After stratification by mean age, gender, recruitment, diagnostic criteria, and measuring methods, no significant difference of BMD was found in bone mineral density of male total hip between MDD and controls(p > .05). Moreover, adults appear to have lower BMD than old cohorts. This is an updated meta‐analysis to reveal the association of bone mineral density and depression, suggesting that BMD appears to be more susceptible to occur in spine, total hip, femoral neck in MDD, especially for adults and women. Our meta‐analysis may provide clinicians and public health administrators with an important screening tool for assessing depression and avoiding osteoporosis in adult subjects and female.
Highlights
The association between Bone mineral density (BMD) and Major depressive disorder (MDD) was assessed by estimating std. mean difference (SMD) and 95% confidence intervals (CIs) Greater weight was commonly considered to be a study of larger samples and higher quality; this procedure corrected the biases associated with small sample sizes
We examined the femoral trochanter BMD in subjects with MDD and controls composed of 3 studies and observed that there is no significant difference of BMD under the femoral trochanter (STD=0.49, 95% confidence intervals (95% CIs)=−0.02 to 1.01, p =.06) between depression and controls (Figure 4)
The std. mean difference (STD) value was 0.41(95% CI=0.16 to 0.66, p =.001) by comparing the BMD between depression and controls, suggesting that the BMD was lower in depression(Figure 5)
Summary
Major depression disorder (MDD) is a kind of mental illness. The typical manifestation is persistent depression and loss of interest (Boku and Nakagawa 2018). Several electronic databases (EMBASE, Google Scholar, Science Direct, Springer, PubMed) were searched systematically to identify all the published studies about the association between BMD and/ or osteoporosis and MDD from January 1990 to January 2019 with those key words: (“osteoporosis” OR “bone mineral density” OR “BMD” OR “bone”) AND (“depression” OR “major depressive disorder” OR “depressive episode” OR “MDD” OR “depression”), and relevant Medical Subject Heading (MeSH) terms were utilized. Two authors (LZ and SYY) independently obtained data to avoid extraction bias and discussed the differences to reach agreement
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