Prevalence and Factors Associated With Decreased Bone Mineral Density in Young and Middle-Aged Male Schizophrenic Patients

Objective: The prevalence and factors of decreased bone mineral density (BMD) in young and middle-aged schizophrenic male subjects were examined in this study. Methods: The sample included male patients, diagnosed with schizophrenia, between 18 and 45 years old. In the large-sample, cross-sectional study, cluster sampling method was adopted. 200 male inpatients in total, between 18 and 45 years old, diagnosed with schizophrenia, were included and interviewed in Beijing. The clinical assessment instruments included the Positive and Negative Syndrome Scale (PANSS) and a questionnaire with disease-related investigations and general information. The laboratory measurements concluded calcium, phosphorus, total cholesterol, prolactin (PRL), thyroid stimulating hormone, fT3, T3, fT4, T4, testosterone and fasting blood-glucose (FBG). Dual-energy X-ray absorptiometry was used to test BMD. Results: The prevalence of osteopenia or osteoporosis was 33.5% (n=67). The prevalence of fracture in decreased BMD group was 17.9%12/67, significantly higher than that in the normal BMD group 8.3%11/133(p<0.05). Decreased BMD was associated with PANSS-negative scores, PANSS-total scores, body mass index (BMI), smoking and weight. Multiple logistic regression analysis revealed that BMI and PANSS-negative score had statistically significant difference between two groups. Conclusion: Prevalence of decreased bone mineral density was higher in young and middle-aged male subjects with schizophrenia in China. And the prevalence of fracture was more than twice in the decreased BMD group compared with the normal BMD group. PANSS-negative symptom was a risk factor, while BMI was a protective factor.