Abstract
Purpose:The purpose of this study was to examine the association between depressive symptoms and bone mineral density (BMD).Methods:Depressive symptoms were measured using the Center for Epidemiologic Studies Depression (CES-D) scale. BMD of total hip, femoral neck, anterio-posterior (AP) spine, wrist, and total body were measured by DXA using standardized procedures. Mean levels of BMD across gender-specific tertiles of CES-D score were obtained using ANOVA and ANCOVA.Results:Participants included 97 police officers (41 women; 29-64 years). Depressive symptoms were not associated with BMD at any site among men. However among women, mean BMD values decreased across increasing (worsening) tertiles of CES-D for the AP spine (low CES-D=1.22 ± 0.04; medium CES-D=1.05±0.04; high CES-D=1.03±0.04 g/cm2; p=0.035) and for the whole body (low=1.26±0.03; medium=1.20±0.03; high=1.11±0.03 g/cm2; p=0.018) after adjustment.Conclusions:Higher depressive symptoms were associated with lower BMD among female but not male officers.
Highlights
Osteoporosis, a disease characterized by low bone mineral density (BMD) and increased risk of fractures, is a major public health problem that is prevalent among the populations of developed and developing countries (Looker et al, 2010; Holt et al, 2002; Aggarwal et al, 2011; Lippurer, 2012; Kim et al, 2012)
Analyses to determine mediation suggested that 51-67% of the association between depression and bone density could be attributed to stress-induced changes in cortisol.The authors suggested that cortisol hyper-secretion in response to stress may partially explain the negative impact of depression on bone mineral density
Regardless of the sensitivity analyses attempted, Center for Epidemiologic Studies Depression (CES-D) score was not associated with BMD at any location among men. In this cohort of female and male police officers, we examined the association between depressive symptoms and BMD at five anatomical sites
Summary
Osteoporosis, a disease characterized by low bone mineral density (BMD) and increased risk of fractures, is a major public health problem that is prevalent among the populations of developed and developing countries (Looker et al, 2010; Holt et al, 2002; Aggarwal et al, 2011; Lippurer, 2012; Kim et al, 2012). Analyses to determine mediation suggested that 51-67% of the association between depression and bone density could be attributed to stress-induced changes in cortisol.The authors suggested that cortisol hyper-secretion in response to stress may partially explain the negative impact of depression on bone mineral density. These analyses were not conducted in the present study but they are worthwhile of future investigations
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