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Depression and Osteoporosis Linked in Women

by Teri Robert

Recently released study data give women with depression yet another reason to work to minimize risks for osteoporosis. The study showed that premenopausal women with depression have less bone mass than women without depression and are more likely to reach menopause with a higher risk of osteoporosis. The level of bone loss is at least as high as that associated with recognized risk factors for osteoporosis, including smoking, low calcium intake, and lack of physical activity. The hip bones, which are often a frequent fracture site among older people, were among those displaying the most thinning in premenopausal women with depression.

Study methods:
Bone mass density (BMD) was measured by dual-energy x-ray absorptiometry at the spine, hip, and forearm. Hourly levels were checked for plasma 24-hour cytokines, 24-hour urinary free cortisol, and catecholamine excretion.

  • Included 89 women with depression and 44 women without depression.
  • The participants were ages 21 - 45.
  • Other than depression, the two groups of women had similar risk factors including calcium, caffeine, and alcohol intake; smoking; level of physical fitness; use of oral contraceptives; and age of first menstrual period.

Study results:

  • Thinner bone in the femoral neck of the hip: 17% of the women with depression, 2% of the women without depression.
  • Low bone mass in the lumbar spine (lower back): 20% of the women with depression, 9% of the women without depression.
  • The level of bone loss was at least as high as that associated with known risk factors such as smoking, poor diet and lack of exercise.

Blood and urine analysis showed that women with depression have imbalances in immune-system substances, including those that produce inflammation. The immune-system imbalances may be tied to excess adrenalin, since the part of the nervous system that produces adrenalin is over-active in depressed people. The immune-system imbalance may be linked to excessive adrenalin. It is know that depressed people produce more adrenalin - adrenalin can over-stimulate the immune system. Compared to the others, the depressed women in this study had higher levels of immune-system proteins that promote inflammation, and lower levels of those that prevent it. One of these inflammation-promoting proteins, IL-6, is known to promote bone loss.

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