Lower Bone Mineral Density at the Hip and Lumbar Spine in People with Psychosis Versus Controls: a Comprehensive Review and Skeletal Site-Specific Meta-analysis

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chlorpromazine 2 endocrinologydiseasesdrugs
osteoporosis 18 endocrinologydiseases

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Select Drug Character Offset Drug Term Instance
chlorpromazine 13595 pretreatment821.14 ± 0.1528 aripiprazole29.7916.0347.0226.8PS, post-treatment1.16 ± 0.1826 chlorpromazine 32.8117.4245.9927 perphenazine28 sulpirideHCM90471.28 ± 0.1534.2 ± 10.648n/an/an/a25.3n/aF431.28 ± 0.13[[]]Van
chlorpromazine 21954 FGAs (31.73 ± 22.16 ng/ml before, and 53.05 ± 30.25 ng/ml after treatment). FGAs used were chlorpromazine , perphenazine and sulpiride, all of which are PRL raising. There was a small increase in PRL for patients
Select Disease Character Offset Disease Term Instance
osteoporosis 1904 also carries an increased risk of fracture [[]]. Worldwide, 200 million people are estimated to have osteoporosis [[]]. The fragility fractures commonly resulting from this condition are associated with an increase
osteoporosis 2229 experience poorer general health outcomes than the general population, including an increased risk of osteoporosis [[]••]. The mechanism underlying reduced bone mineral density (BMD) in schizophrenia is not yet
osteoporosis 2904 a role in the development of reduced BMD in people with schizophrenia [[]]. Other risk factors for osteoporosis such as smoking, excessive alcohol consumption, lack of physical activity, diabetes and vitamin D deficiency
osteoporosis 3151 in people suffering from psychotic illnesses [[], []•] and likely contribute to the development of osteoporosis in this patient group.A recent meta-analysis demonstrated that over half (51.7 %) of people with schizophrenia
osteoporosis 3466 ratio (OR) = 2.86, CI = 1.27–6.42, p = 0.01 [[]••]). This increased prevalence of osteoporosis and osteopenia in patients with schizophrenia is of particular concern because of their increased risk
osteoporosis 4731 meta-analysis to investigate differences between skeletal sites (e.g. hip, lumbar spine) affected by osteoporosis and osteopenia in people with schizophrenia versus healthy controls. In addition, we sought to identify
osteoporosis 7661 Embase, AGRIS and PsychARTICLES from inception until February 2016 using the following search terms: ( osteoporosis or osteopenia or osteo* or BMD or DXA or DEXA) and (schizophrenia or schizo* or psychosis or antipsychotics)
osteoporosis 12260 five also measured BMD at the hip [[], [], []–[]]. Information regarding potential risk factors for osteoporosis was varied, with data on PRL levels available in four studies [[], [], [], []] and vitamin D levels
osteoporosis 21018 also had hyperprolactinaemia. Sustained amenorrhea has previously been identified as a risk factor for osteoporosis [[]]. This study from Jung et al. found no significant correlation between BMD and PRL, follicle stimulating
osteoporosis 23085 hypothalamic-pituitary-gonadal axis and thus that antipsychotic medication may play a role in the development of osteoporosis in patients with schizophrenia.Studies Investigating Familial Risk of Psychotic Disorders and Low BMDVan
osteoporosis 25475 patients.Studies Investigating BMD Patients Over 50Jung et al. [[]] found an increased prevalence of osteoporosis in 229 patients with schizophrenia aged 50 or older compared with healthy age-matched controls (34.9
osteoporosis 25791 significant gender difference, with 48.4 % of females with schizophrenia showing evidence of osteopenia or osteoporosis compared with 25.7 % males (p = 0.0014). There were no sex differences in prevalence of low BMD
osteoporosis 26585 skeletal sites may indicate that the lumbar spine is a better site at which to carry out screening for osteoporosis in patients with schizophrenia. Our meta-regression analysis suggests that hyperprolactinaemia and smoking
osteoporosis 28583 cigarette consumption amongst those who smoke [[], []], factors which can contribute to the development of osteoporosis [[], []•]. The effects of smoking on BMD found in this study further indicate the need to develop
osteoporosis 28836 cessation amongst those with schizophrenia.Antipsychotic medication was identified as a risk factor for osteoporosis in the narrative review, with PRL-raising antipsychotics having a larger impact on bone health than
osteoporosis 29821 optimum peak bone mass from being achieved, thus reducing lifelong BMD and predisposing patients to osteoporosis . Our study findings should be viewed in relation to the recognition that sustained hyperprolactinaemia
osteoporosis 31639 prevent fractures would be considered. It may be necessary to adapt guidelines to manage the risk of osteoporosis in people with schizophrenia, perhaps by introducing a modified T-score as a threshold for medical intervention
osteoporosis 31853 intervention regardless of age. Careful assessment for modifiable risk factors for the development of osteoporosis in schizophrenia such as smoking, hyperprolactinaemia, and vitamin D deficiency, and appropriate treatment

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