People with schizophrenia may have increased bone fragility risk, finds study

A new study by Behnaz Azimi Manavi and team showed that individuals diagnosed with schizophrenia had markedly reduced bone mineral density (BMD) in the lumbar spine and femoral neck, where osteoporotic fractures are more common. The findings of this study were published in the journal of Translational Psychiatry.

Decreased bone stiffness, low bone mineral density, disturbance of the microarchitecture of the bone, and an increased risk of fracture, especially at the hip, spine, and wrist, are the hallmarks of osteoporosis. A popular technique for estimating fracture risk is dual energy x-ray absorptiometry, or DXA, which analyzes arterial bone mineral density. Thus, bone health has been linked to several medical diseases and a few behavioral illnesses. There is mounting data that indicates a greater frequency of medical comorbidities, such as osteoporosis and fractures, among the individuals with schizophrenia. The purpose of this systematic review and meta-analysis was to determine if schizophrenia and bone fragility are related.

The PECO (Population, Exposure, Comparison, Outcome) framework guided the development and presentation of the study question, inclusion and exclusion criteria. The DSM-IV/5, the ICD, or medical records were used to diagnose schizophrenia. Bone fragility [i.e., bone mineral density (BMD), bone turnover indicators, fracture, and bone quality] was the end point of this review. A search plan was created and put into practice for the electronic databases. Every included study underwent a narrative synthesis, and a meta-analysis was conducted by pooling the data from relevant studies that reported on fracture and BMD using a random effects model.

Out of the 3103 studies that this research produced, 29 satisfied the predefined qualifying requirements. 37 publications from 29 research comprised 17 studies looking at bone mineral density (BMD), 8 studies looking at fracture, 3 studies looking at bone quality and 9 studies looking at indicators of bone turnover. The lumbar spine and femoral neck BMDs were shown to be lower in individuals with schizophrenia, according to the meta-analyses. There was also evidence of an increased fracture risk. The relationship between schizophrenia and femoral neck BMD and fracture persisted even when publication bias was taken into account.

The outcomes of this meta-analysis and systematic review support the idea that individuals with schizophrenia may have fragile bones. Overall, the individuals diagnosed with schizophrenia specifically have decreased bone mineral density (BMD), especially around the femoral neck, increased fracture risk, decreased bone quality, and accelerated bone turnover.

Reference:

Azimi Manavi, B., Corney, K. B., Mohebbi, M., Quirk, S. E., Stuart, A. L., Pasco, J. A., Hodge, J. M., Berk, M., & Williams, L. J. (2024). The neglected association between schizophrenia and bone fragility: a systematic review and meta-analyses. In Translational Psychiatry (Vol. 14, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1038/s41398-024-02884-1