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Depression and low bone mineral density: a meta-analysis of epidemiologic studies

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Abstract

Summary

The association between depression and loss of bone mineral density (BMD) has been reported inconsistently. This meta-analysis, which pooled results from 14 qualifying individual studies, found that depression was associated with a significantly decreased BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression.

Introduction

The reported association between depression and loss of BMD has been controversial. This meta-analysis was conducted to determine whether depression and BMD are associated and to identify the variation in some subgroups.

Methods

English-language articles published before October 2008 were used as the data source. A total of six case-controlled and eight cross-sectional studies met prestated inclusion criteria (N = 10,523). Information on study design, participant characteristics, measurements of BMD and depression, and control for potential confounders was abstracted independently by two investigators using a standardized protocol.

Results

Overall, depression was associated with a significant decrease in mean BMD of spine (−0.053 g/cm2 [95% confidence interval {CI} −0.087 to −0.018 g/cm2]) and hip (−0.052 g/cm2 [95% CI −0.083 to −0.022 g/cm2]). A substantially greater BMD decrease was observed in depressed women (−0.076 g/cm2 in spine; −0.059 g/cm2 in hip) and in cases of clinical depression (−0.074 g/cm2 in spine; −0.080 g/cm2 in hip).

Conclusion

Depression is associated with low BMD, with a substantially greater BMD decrease in depressed women and in cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.

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Abbreviations

BMD:

Bone mineral density

BMI:

Body mass index

CI:

Confidence interval

DSM:

Diagnostic and Statistical Manual of Mental Disorders

ROI:

Region of interest

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Authors and Affiliations

  1. Biostatistics, Mayo Clinic, 13400 East Shea Blvd, Scottsdale, AZ, 85259, USA

    Q. Wu & J. G. Hentz

  2. Department of Community of Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA

    J. H. Magnus

  3. Department of Biostatistics, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA

    A. F. Bencaz

  4. College of Arts and Letters, Northern Arizona University, Flagstaff, AZ, USA

    J. Liu

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  1. Q. Wu
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  2. J. H. Magnus
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  3. J. Liu
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  4. A. F. Bencaz
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  5. J. G. Hentz
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Correspondence to Q. Wu.

Additional information

Presented in part at Joint Meeting of the Statistical Society of Canada and the Société Française de Statistique, Ottawa, Canada, May 27, 2008.

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Wu, Q., Magnus, J.H., Liu, J. et al. Depression and low bone mineral density: a meta-analysis of epidemiologic studies. Osteoporos Int 20, 1309–1320 (2009). https://doi.org/10.1007/s00198-009-0918-x

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  • DOI: https://doi.org/10.1007/s00198-009-0918-x

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