Long-term second-generation antipsychotics decreases bone formation and resorption in male patients with
Fan Wang1,2,3, Hui Li4, Kaijun Yi5
1Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China. FanWang@bjmu.edu.cn.
Rationale:
Patients with schizophrenia with second-generation antipsychotics (SGAs) treatment have shown an increased risk of bone fragility and susceptibility to fracture; however, it is still unclear whether this risk is derived from the effect of antipsychotics on balance of bone metabolism.
Objectives:
We investigated the changes of two bone turnover biomarkers (BTMs) concentrations in people with schizophrenia receiving SGAs: procollagen type I aminoterminal propeptide (PINP) and C-terminal telopeptide of type I collagen (CTX-1) as BTMs of osteogenesis and bone resorption, respectively, to explore how antipsychotics contribute to bone fragility.
Methods:
We recruited 59 Chinese male patients with schizophrenia (32 drug-naïve first-episode (DNFE) patients and 27 chronic patients) to undergo 8 weeks SGAs treatment. Fasting peripheral blood samples of pre- and posttreatment were collected, plasma levels of PINP and CTX-1 were measured.
Results:
The interaction effects of group and time on PINP and CTX-1 concentrations were found (P = .016 and P = .008). There was a significant decrease for both BTMs concentrations of the posttreatment compared to the pretreatment (P<.001 and P = .003). Chronic patients had significantly higher changes of BTMs concentrations compared to DNFE patients (P = .048 and P = .024). There was a positive correlation of the two BTMs of pretreatment with disease course in DNFE group (r = .37, P = .039;r = .38, P = .035) and a negative correlation of PINP of pretreatment with age in the chronic group (r=-.40, P = .039).
Conclusion:
Long-term SGAs medication inhibited osteogenesis in a dose- and time-dependent manner and damaged the balance of bone formation and bone resorption.
Insights
Second-generation antipsychotics (SGAs) treatment in schizophrenia patients inhibited bone formation and resorption, damaging bone metabolism balance. This study investigated bone turnover biomarkers (PINP and CTX-1) to understand SGA effects on bone fragility.
Area of Science:
- Biomedical Science
- Pharmacology
- Metabolic Bone Disease
Background:
- Second-generation antipsychotics (SGAs) are linked to increased bone fragility and fracture risk in schizophrenia patients.
- The precise impact of SGAs on bone metabolism balance remains unclear.
Purpose of the Study:
- To investigate changes in bone turnover biomarkers (BTMs) including procollagen type I aminoterminal propeptide (PINP) and C-terminal telopeptide of type I collagen (CTX-1) in schizophrenia patients treated with SGAs.
- To explore how SGAs contribute to bone fragility by examining their effects on osteogenesis and bone resorption.
Main Methods:
- Recruitment of 59 Chinese male schizophrenia patients (32 drug-naïve first-episode, 27 chronic).
- 8-week treatment with SGAs, with blood samples collected pre- and post-treatment.
- Measurement of plasma levels of PINP and CTX-1 to assess bone formation and resorption markers.
Main Results:
- Significant interaction effects of group and time on PINP and CTX-1 concentrations were observed (P=.016 and P=.008).
- Both BTMs significantly decreased post-treatment compared to pre-treatment (P<.001 and P=.003).
- Chronic patients showed significantly greater changes in BTMs compared to drug-naïve first-episode patients (P=.048 and P=.024).
Conclusions:
- Long-term SGA medication inhibits osteogenesis in a dose- and time-dependent manner.
- SGAs disrupt the balance between bone formation and bone resorption, contributing to bone fragility.
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