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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

L. Gomez,B. Stubbs,Ayala Shirazi,D. Vancampfort,F. Gaughran,J. Lally

Published 2016 in Current Osteoporosis Reports

ABSTRACT

It remains unclear if differences in bone mineral density (BMD) exist at different skeletal sites between people with schizophrenia and age- and sex-matched healthy controls (HCs). Major databases were searched from inception until February 2016 for studies measuring BMD using dual-energy X-ray absorptiometry (DXA) at any skeletal site in individuals with schizophrenia. Ten studies investigating 827 people with schizophrenia (55.4 % female, 33.8 ± 9.7 years) and 1379 HCs (58.7 % female, 34.7 ± 9.1 years) were included. People with schizophrenia had significantly reduced BMD at the lumbar spine (standardised mean difference adjusted for publication bias (SMD) = −0.950 (95 % CI = −1.23 to −0.66, fail-safe number = 825) and hip (SMD = −0.534, 95 % CI = −0.876 to −0.192, fail-safe number = 186). A higher proportion of hyperprolactinaemia (β = −0.0102, p < 0.0001) and smokers (β = −0.0099, p = 0.02) moderated a larger reduced BMD at the lumbar spine. Further research is required to investigate if low bone mass and fractures can be prevented in people with schizophrenia.

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