Long-term second-generation antipsychotics decreases bone formation and resorption in male patients with schizophrenia

Fan Wang; Hui Li; Kaijun Yi; Yan Wu; Qingtao Bian; Baoyan Guo; Xingguang Luo; Yimin Kang; Qi Wu; Qinghe Ma

doi:10.1007/s00213-024-06592-y

Long-term second-generation antipsychotics decreases bone formation and resorption in male patients with schizophrenia

Psychopharmacology (Berl). 2024 Apr 22. doi: 10.1007/s00213-024-06592-y. Online ahead of print.

Authors

Fan Wang^#^{1

2

3}, Hui Li⁴, Kaijun Yi⁵, Yan Wu⁶, Qingtao Bian⁶, Baoyan Guo⁷, Xingguang Luo⁸, Yimin Kang⁹, Qi Wu^{10

11}, Qinghe Ma^{11

12}

Affiliations

¹ Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China. FanWang@bjmu.edu.cn.
² Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China. FanWang@bjmu.edu.cn.
³ Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, 010110, China. FanWang@bjmu.edu.cn.
⁴ Department of Biomedical Engineering, College of Future Technology, Peking University, Beijing, 100871, China.
⁵ Department of Orthopedics, Xiangyang No. 1 People's Hospital Affiliated to Hubei University of Medicine, Xiangyang, 441000, Hubei, China.
⁶ Beijing Hui-Long-Guan Hospital, Peking University, Beijing, 100096, China.
⁷ Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, 830063, China.
⁸ Department of Psychiatry, Yale University School of Medicine, New Haven, CT, 06510, USA.
⁹ Medical Neurobiology Lab, Inner Mongolia Medical University, Huhhot, 010110, China.
¹⁰ Fenyang College, Shanxi Medical University, Lvliang, 032200, China.
¹¹ Department of Psychiatry, Changzhou Peace Hospital, The 102nd Hospital of The Chinese People's Liberation Army, Changzhou, 213003, China.
¹² Department of Internal Medicine, The 904th Hospital of The Chinese People's Liberation Army, Wuxi, 214004, China.

^# Contributed equally.

PMID: 38647696
DOI: 10.1007/s00213-024-06592-y

Abstract

Rationale: Patients with schizophrenia with second-generation antipsychotics (SGAs) treatment have shown an increased risk of bone fragility and susceptibility to fracture; however, it is still unclear whether this risk is derived from the effect of antipsychotics on balance of bone metabolism.

Objectives: We investigated the changes of two bone turnover biomarkers (BTMs) concentrations in people with schizophrenia receiving SGAs: procollagen type I aminoterminal propeptide (PINP) and C-terminal telopeptide of type I collagen (CTX-1) as BTMs of osteogenesis and bone resorption, respectively, to explore how antipsychotics contribute to bone fragility.

Methods: We recruited 59 Chinese male patients with schizophrenia (32 drug-naïve first-episode (DNFE) patients and 27 chronic patients) to undergo 8 weeks SGAs treatment. Fasting peripheral blood samples of pre- and posttreatment were collected, plasma levels of PINP and CTX-1 were measured.

Results: The interaction effects of group and time on PINP and CTX-1 concentrations were found (P = .016 and P = .008). There was a significant decrease for both BTMs concentrations of the posttreatment compared to the pretreatment (P<.001 and P = .003). Chronic patients had significantly higher changes of BTMs concentrations compared to DNFE patients (P = .048 and P = .024). There was a positive correlation of the two BTMs of pretreatment with disease course in DNFE group (r = .37, P = .039;r = .38, P = .035) and a negative correlation of PINP of pretreatment with age in the chronic group (r=-.40, P = .039).

Conclusion: Long-term SGAs medication inhibited osteogenesis in a dose- and time-dependent manner and damaged the balance of bone formation and bone resorption.

Keywords: Bone formation; C-terminal telopeptide of type I collagen; Procollagen type I aminoterminal propeptide; Schizophrenia; Second-generation antipsychotic.

Abstract

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