As a risk factor for low bone mineral density (BMD) in premenopausal women, depression is comparable in magnitude to established risks like smoking and low calcium intake, say the authors of a study published in the Archives of Internal Medicine (2007; 167 , 2329–36). Early findings from the POWER Study Group, based at Case Western Reserve University in Cleveland, have revealed that low BMD is more common in women with depression than it is in healthy women.
Researchers recruited 89 premenopausal women with depression and 44 healthy control subjects for a 3-year study on bone turnover and other measures of hormonal activity. Baseline data showed that of the women with depression, 17% had low BMD at the upper end of the thighbone and 15% had low BMD in the hip. Among the controls, the percentage was just 2% for each area. Women with depression also had higher levels of stress hormones, which contribute to inflammation, and lower levels of anti-inflammation hormones.
“The practical message is depression is a risk factor for osteoporosis,” said study author Giovanni Cizza, MD, PhD, MHSc, in an interview with Medscape Psychiatry. “The novelty of this study is the fact that these women were not severely depressed. They were mildly depressed, and yet they had bone loss of clinical significance, so . . . within the population of women with depression [the test should be prescribed to] almost everybody, not only the more severely depressed women, or those with a long duration of depression.”Scientists will continue analyzing data to determine what happens to these women over the 3 years. In particular, investigators will examine the relationship between the imbalance of immune and inflammatory factors and BMD loss.