| Objective:Schizophrenia is a serious mental disease and patients often require long-term oral antipsychotics.Patients who have taken antipsychotics for a long time tend to suffer from low bone density and osteoporosis,and the risk of femoral neck fractures is increased by about two times.This study explored the status of bone mineral density(BMD),serum prolactin(PRL),bone-specific alkaline phosphatase(BAP),tartrate resistant acid phosphatase 5b(TRACP-5b),estradiol(E2)and testosterone(T)level in chronic male schizophrenia.And the correlations between BMD and the levels of serum BAP,TRACP-5b,PRL,E2,T were also investigated in this study.,Methods:A total of 83 male schizophrenic patients who were hospitalized in Yangzhou Wutaishan Hospital of Jiangsu province from September 2016 to June 2017(hospitalized time more than 5 years)and 62 matched male normal controls were enrolled.The positive and negative symptom scale(PANSS)was used to evaluate the mental symptoms of schizophrenic patients.The lumbar spine BMD values of all the subjects were measured by quantitative computed tomography(QCT);Meanwhile,the levels of serum BAP and TRACP-5b were measured by enzyme-linked immunosorbent assay(ELISA)and serum PRL,E2 and T levels of all subjects were detected by chemiluminescence.Results:1.The BMD of the patient group(n=83)and the normal group(n=62)were(108.8±26.9)mg/cm3 and(124.5±27.1)mg/cm3 respectively,with significant differences between the two groups(p<0.01).In the patient group,there were 32 cases of normal bone mass(38.6%),36 cases of bone mass reduction(43.3%),15 cases of osteoporosis(18%),but 39 cases of normal bone mass(62.9%),18 cases of BMD reduction(29%)and 5 cases of osteoporosis(8.1%)in the normal control group,and there was significant difference between the two groups(p<0.05).2.The serum concentration of TRACP-5b in the patients group and the normal group were(4.8±1.3)U/L and(4.1±1.4)U/L respectively;The difference between the two groups was significant(p<0.01).The serum BAP concentration of the patients and the normal control group were(28.3±9.4)U/L and(30±7.5)U/L respectively,and there was no significant difference in the two groups(p>0.05).The levels of serum PRL in the patients group and the normal group were(28.8±11.7)ng/ml and(13.6±10.2)ng/ml respectively;The difference between the two groups was significant(p<0.01).The concentration of serum E2 in the patients group and the normal group were(55.2±14)pmol/L and(72.4±16.6)pmol/L respectively,and there was a significant difference between the two groups(p<0.01).However,the concentration of serum T in the patient group was(13.5±3.8)nmol/L and the concentration of serum T in the normal group was(14.6±4.3)nmol/L and there was no significant difference between the two groups(p>0.05).3.According to serum PRL concentration,the patients were divided into the PRL-elevated group(PRL>25ng/m,n=41)and the PRL-normal group(PRL concentration<25ng/ml,n=42),then compared with the normal control group.The difference between the three groups was statistically significant(p<0.01).The BMD in the PRL-elevated group,the PRL-normal group and the normal control group were(102.5±25.7)mg/cm3,(114.9±26.9)mg/cm3 and(124.5±27.1)mg/cm3 respectively,and the difference between the three groups was statistically significant(p<0.01);LSD post test showed that BMD in PRL-elevated was significantly lower than that in PRL-normal group and normal control group(p<0.05;p<0.01).The difference of serum BAP,TRACP-5b,E2,and T concentration in the PRL-elevated group,PRL-normal group and normal control group was statistically significant(p<0.01).4.Correlation analysis revealed that BMD in the chronic male schizophrenia group was significantly and negatively correlated with serum PRL(r=-0.366,p=0.001),TRACP-5b(r=-0.274,p=0.012);and significantly positively correlated with serum BAP(r=0.2875,p=0.009),E2(r=0.248,p=0.024),T(r=0.370,p=0.001).Conclusions:1.The BMD in chronic male schizophrenia patients was significantly lower than that in the normal control group.The incidence of osteoporosis and serum TRACP-5b level were significantly higher than that in the normal control group.It shows that patients with schizophrenia are more likely to have increased bone metabolism,bone mass loss or osteoporosis than normal people.2.The possible influence factor of BMD decline in chronic male schizophrenia patients is the increased serum PRL levels.3.There was a correlation between serum PRL,BAP,TRACP-5b,T,E2 levels and BMD in chronic male schizophrenia patients. |
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