Bone mineral density as a marker of cumulative endogenous estrogen exposure: Relationship to background genetic risk of psychotic disorder

C. van der Leeuw, P. Habets, P. Domen, M. van Kroonenburgh, J. van Os, M. Marcelis*

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

9 Citations (Scopus)

Abstract

Background: Alterations in bone mineral density (BMD) in patients with psychotic disorder may reflect the effect of treatment (disease effect observed in patients but not their siblings) or, as an intermediate marker of cumulative endogenous estrogen exposure, alterations in the neuroprotective effect of estrogen in the brain (vulnerability effect observed in patients and siblings). Methods: Dual X-ray absorptiometry (DEXA) scans were acquired in 62 patients with a psychotic disorder, 67 non-psychotic siblings of patients with a psychotic disorder, and 48 controls. BMD (g/cm2), Z-scores and T-scores were measured in the lumbar spine and proximal femur. Associations between group and BMD were investigated with multilevel random regression analyses. Group×sex interactions and effects of antipsychotic medication (AP) on BMD were examined. Results: Group was not associated with BMD outcome measures, although patients had consistently lower BMD measures compared to both siblings and controls. There were no significant group × sex interactions, but stratified analyses showed that BMD measures in female patients were significantly lower in comparison to female controls and siblings (e.g. total femoral BMD, P vs. C: B = - 0.100, p = 0.010; P vs. S: B = - 0.104, p = 0.008). After excluding female patients who used prolactin-raising AP, the effect was attenuated (e.g. total femoral BMD, P vs. C: B = - 0.073, p = 0.072; P vs. S: B = - 0.085, p = 0.051). In men, there were no significant BMD differences between patients and controls. Conclusion: Familial risk of psychotic disorder was not associated with BMD. Instead, decreased BMD in the femur may reflect treatment effects or non-familial risk associated with low cumulative endogenous estrogen levels in women.

Original languageEnglish
Pages (from-to)25-31
Number of pages7
JournalSchizophrenia Research
Volume143
Issue number1
DOIs
Publication statusPublished - Jan 2013
Externally publishedYes

Keywords

  • Bone mineral density
  • Endophenotype
  • Estrogen
  • Genetics
  • Psychotic disorder
  • Schizophrenia

Fingerprint

Dive into the research topics of 'Bone mineral density as a marker of cumulative endogenous estrogen exposure: Relationship to background genetic risk of psychotic disorder'. Together they form a unique fingerprint.

Cite this