Bone mineral density and bone metabolism in elderly males with femoral neck fractures and depression

doi:10.3877/cma.j.issn.1674-134X.2020.04.008

Abstract

Abstract:

Objective

To analyze the changes of bone mineral density and biochemical markers of bone metabolism in elderly males with femoral neck fractures and depression, and to investigate the effect of depression on osteoporosis and bone metabolism.

Methods

Between January 2017 and January 2019 in Beijing Hospital, onehundredandtwo elderly males with femoral neck fractures were enrolled in the study.Pathological fracture and cognitive impairment were excluded. All the patients were divided into the depression group(52 cases) and the control group(50 cases) by geriatric depression scale (GDS). Bone mineral density (BMD) was detected using dual X-ray densitometry (DEXA). Bone metabolism biochemical markers, such as procollagen type Ⅰ N-peptide (P1NP), β isomer of C-terminal telopeptide of type Ⅰ collagen (β-CTX), osteocalcin(OC), 25-OH-VitD, alkaline phosphatase (ALP), calcium and phosphorus, were measured using enzyme linked immunosorbent assay (ELISA) method.Correlation of depression, bone metabolism and BMD was analyzed.The data were analyzed by chi-square test, t test, and Pearson correlation analysis.

Results

BMD of depression group was significantly lower than that of control group(lumbar t=5.964, hip neck t =2.845, P<0.05). Depression group(Compared with control group): the serum levels of 25(OH)D, OC, ALP and calcium were lower with statistically significant differences(t=3.077, 2.013, 2.111, 2.020, all P<0.05). β-CTX and phosphorus level were higher(t=2.938, 3.099, both P<0.05). No significant difference in P1NP (t =0.684, P>0.05). Depression scores were negatively correlated with BMD(r=-0.456, P<0.05), 25(OH)D (r=-0.546, P<0.05), OC (r=-0.215, P<0.05) and positively correlated with β-CTX(r=0.372, P<0.05), but not significantly correlated with P1NP (r=-0.115, P>0.05).

Conclusion

Depression is accompanied by the decrease of bone formation and increase of bone resorption, which is a risk factor for low bone density and fractures, so attention should be paid to the detection of bone metabolism makers and 25(OH)D in elderly patients with depression, and treating the osteoporosis in time.

Key words: Osteoporosis, Femoral neck fracture, Depression, Vitamin D, Bone mineral density

Chi Liu, Lei Shi, Jing He, Junchuan Liu, Maoyu Zhao, Yaonan Zhang, Qingyun Xue. Bone mineral density and bone metabolism in elderly males with femoral neck fractures and depression[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(04): 435-439.

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References 29

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组别	例数	年龄[岁，(±s)]	身高[cm，(±s)]	体重[kg，(±s)]	BMI[kg/m²，(±s)]	吸烟情况(是/否)	慢性疾病病史(有/无)	有无配偶(无/有)	教育程度[年，(±s)]
抑郁组	52	74.6±5.3	174.3±3.9	68.5±5.4	22.8±1.3	20/32	35/17	23/29	9.4±1.4
对照组	50	75.2±3.1	173.5±4.7	69.6±4.4	23.1±0.9	18/32	34/16	12/38	11.9±1.7
统计值		t＝0.694	t＝0.937	t＝1.125	t＝1.350	χ²＝0.066	χ²＝0.006	χ²＝4.629	t＝7.757
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05	<0.01

组别	例数	年龄[岁，(±s)]	身高[cm，(±s)]	体重[kg，(±s)]	BMI[kg/m²，(±s)]	吸烟情况(是/否)	慢性疾病病史(有/无)	有无配偶(无/有)	教育程度[年，(±s)]
抑郁组	52	74.6±5.3	174.3±3.9	68.5±5.4	22.8±1.3	20/32	35/17	23/29	9.4±1.4
对照组	50	75.2±3.1	173.5±4.7	69.6±4.4	23.1±0.9	18/32	34/16	12/38	11.9±1.7
统计值		t＝0.694	t＝0.937	t＝1.125	t＝1.350	χ²＝0.066	χ²＝0.006	χ²＝4.629	t＝7.757
P值		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	<0.05	<0.01

组别	例数	腰椎	髋部
抑郁组	52	0.72±0.08	0.60±0.04
对照组	50	0.84±0.12	0.65±0.12
t值		5.964	2.845
P值		<0.01	<0.01

组别	例数	腰椎	髋部
抑郁组	52	0.72±0.08	0.60±0.04
对照组	50	0.84±0.12	0.65±0.12
t值		5.964	2.845
P值		<0.01	<0.01

组别	例数	25 (OH) D(μg/L)	OC(μg/L)	P1NP(μg/L)	β-CTX(μg/L)	ALP(U/L)	血钙(mmol/L)	血磷(mmol/L)
抑郁组	52	8.10±3.02	11.82±4.45	37.15±15.61	0.63±0.15	71.16±15.65	2.08±0.12	1.19±0.12
对照组	50	10.21±3.87	13.73±5.12	39.32±16.45	0.50±0.28	78.75±20.43	2.13±0.13	1.10±0.17
t值		3.077	2.013	0.684	2.938	2.111	2.020	3.099
P值		<0.01	<0.05	>0.05	<0.01	<0.05	<0.05	<0.01

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