Izvorni znanstveni članak
Depressive Disorder as Possible Risk Factor of Osteoporosis
M. Vrkljan
V. Thaller
I. Lovričević
P. Gaćina
J. Rešetić
M. Bekić
Z. Sonicki
Sažetak
Hipothalamo-pituitary-adrenal (HPA) axis is a very complicated control system
playing an important role in stress reaction, where glucocorticoids suppress the autonomic
(vegetative), endocrine, immunologic and psychic responses to stressful stimuli.
We described the marked clinical, physiological, and biochemical connection between osteoporosis
and major depressive disorder (MDD). Both conditions are associated with a
hyperactive HPA axis and LC/NE system, and hence with increased CRH, cortisol, and
catecholamine secretion. There are numerous states or diseases associated with osteoporosis
and we were looking for a hypercorticism value as a one of these. Some recent studies
demonstrated that earlier history of MDD was associated with marked osteoporosis.
In MDD there are two well-documented biochemical abnormalities: hypercortisolism
and its resistance to dexamethasone suppression. The present study included 31 MDD
patients (19 males and 12 females, mean age 37 1.3, age range 29–41 years), and 17
healthy male volunteers (mean age 39 1.6, age range 34–45 years). In each of our patients
24-hour urinary free cortisol, serum cortisol level at 8 a.m. and 5 p.m., cortisol in
dexamethasone suppression test and bone mineral density were measured. We have,
therefore, analyzed a group of young men and women with normal menstrual cycles,
who were without signs of osteoporosis in the beginning, and who received anti-depressive
therapy for many years. Analysis showed that increased levels of cortisol and the occurrence
of osteoporosis, that developed as the result of elevated cortisol level. For our
workshop we used nonparametric rang-correlation with Spearman’s ro = –0.805, with
statistic significant at the 0.01 level (2-tailed). Patients under long-term history of depression
could develop a very stronger type of osteoporosis i.e. it is before known that the
patients with untreated Cushing syndrome developed hard osteoporosis.
Ključne riječi
Hrčak ID:
28433
URI
Datum izdavanja:
17.12.2001.
Posjeta: 1.428 *