Bone loss linked to depression in new study
Reported November 27, 2007
Depression eats away at a young woman’s bones at least as much as does low calcium, putting women at risk of life-threatening fractures as they get older, new research shows.
Reporting today in the journal, Archives of Internal Medicine, U.S. researchers found women aged 21 to 45 who are mildly depressed have thinner bones at vulnerable spots in their hips and backs than healthy women.
The amount of bone loss is equivalent to one year of rapid bone loss after menopause and is similar in magnitude to what people lose from smoking, failing to exercise or not eating enough calcium.
“Depression generally isn’t on clinicians’ radar screens as a major risk factor for osteoporosis, particularly for pre-menopausal women. It should be,” principal investigator Dr. Giovanni Cizza, of the U.S. National Institute of Mental Health, said in a statement released with today’s study.
An estimated 16 per cent of women between 21 and 45 suffer chronic, mild depression. The researchers estimate that nearly four million depressed women in the U.S. alone are losing bone but don’t know it.
Earlier studies linked depression and frail, brittle bones in hundreds of women with major depression. But it was thought to hold true only in cases of severe depression.
The new study shows even mildly depressed women have “clinically significant” bone loss, Cizza says. What’s more, blood and urine tests showed depressed women produce high amounts of interleukin-6, an immune system protein that destroys bone mass.
Interleukin-6 is sensitive to estrogen. When estrogen levels go down, the protein goes up. This explains why women lose bone after menopause.
“But, we saw it in pre-menopausal women, too,” Cizza says.
The physical consequences of depression are only now starting to be understood. Depression was already known to boost the risk of coronary heart disease. But unlike heart disease, osteoporosis – unless it’s severe and a woman shatters a hip or wrist – is “totally silent,” Cizza says. None of the women in his study realized they were losing bone. Two had full-blown osteoporosis.
The study involved 89 depressed and 44 non-depressed females living in Washington, D.C. Bone mineral density was measured via X-rays at the hip, spine and forearm.
On average, the depressed women had mild symptoms of depression and anxiety. The women suffered their first bout of depression during late adolescence and experienced an average of five episodes of depression.
One in five of the depressed women showed low bone mineral density.
Seventeen per cent had thinner bone in the femoral neck, part of the hip bone that connects the ball of the hip to the thigh bone and a common site for fractures, versus two per cent of those in the non-depressed group.
Twenty per cent of depressed women had low bone mass in the lumbar spine, or lower back, compared to nine per cent of healthy women.
Overall, the depressed women had three per cent less bone at the spine and two per cent less at the hip. “Three per cent is pretty much equivalent to one year rapid, post-menopausal bone loss,” Cizza says.
The study’s biggest limitation is the small sample size. As well, it’s possible the depressed women, for unknown reasons, never reached peak bone mass.
Women with depression should have a bone density test and prescribed drugs or lifestyle changes if needed, Cizza says.
([email protected])Depression eats away at a young woman’s bones at least as much as does low calcium, putting women at risk of life-threatening fractures as they get older, new research shows.
Reporting today in the journal, Archives of Internal Medicine, U.S. researchers found women aged 21 to 45 who are mildly depressed have thinner bones at vulnerable spots in their hips and backs than healthy women.
The amount of bone loss is equivalent to one year of rapid bone loss after menopause and is similar in magnitude to what people lose from smoking, failing to exercise or not eating enough calcium.
“Depression generally isn’t on clinicians’ radar screens as a major risk factor for osteoporosis, particularly for pre-menopausal women. It should be,” principal investigator Dr. Giovanni Cizza, of the U.S. National Institute of Mental Health, said in a statement released with today’s study.
An estimated 16 per cent of women between 21 and 45 suffer chronic, mild depression. The researchers estimate that nearly four million depressed women in the U.S. alone are losing bone but don’t know it.
Earlier studies linked depression and frail, brittle bones in hundreds of women with major depression. But it was thought to hold true only in cases of severe depression.
The new study shows even mildly depressed women have “clinically significant” bone loss, Cizza says. What’s more, blood and urine tests showed depressed women produce high amounts of interleukin-6, an immune system protein that destroys bone mass.
Interleukin-6 is sensitive to estrogen. When estrogen levels go down, the protein goes up. This explains why women lose bone after menopause.
“But, we saw it in pre-menopausal women, too,” Cizza says.
The physical consequences of depression are only now starting to be understood. Depression was already known to boost the risk of coronary heart disease. But unlike heart disease, osteoporosis – unless it’s severe and a woman shatters a hip or wrist – is “totally silent,” Cizza says. None of the women in his study realized they were losing bone. Two had full-blown osteoporosis.
The study involved 89 depressed and 44 non-depressed females living in Washington, D.C. Bone mineral density was measured via X-rays at the hip, spine and forearm.
On average, the depressed women had mild symptoms of depression and anxiety. The women suffered their first bout of depression during late adolescence and experienced an average of five episodes of depression.
One in five of the depressed women showed low bone mineral density.
Seventeen per cent had thinner bone in the femoral neck, part of the hip bone that connects the ball of the hip to the thigh bone and a common site for fractures, versus two per cent of those in the non-depressed group.
Twenty per cent of depressed women had low bone mass in the lumbar spine, or lower back, compared to nine per cent of healthy women.
Overall, the depressed women had three per cent less bone at the spine and two per cent less at the hip. “Three per cent is pretty much equivalent to one year rapid, post-menopausal bone loss,” Cizza says.
The study’s biggest limitation is the small sample size. As well, it’s possible the depressed women, for unknown reasons, never reached peak bone mass.
Women with depression should have a bone density test and prescribed drugs or lifestyle changes if needed, Cizza says.
