Effects of Olanzapine on Bone Mineral Density, Glucose, and Lipid Metabolism in Schizophrenia Patients

Mining Liang; Beibei Zhang; Lu Deng; Rong Xu; Haishan Wu; Jindong Chen

doi:10.1155/2019/1312804

Effects of Olanzapine on Bone Mineral Density, Glucose, and Lipid Metabolism in Schizophrenia Patients

Int J Endocrinol. 2019 Mar 21:2019:1312804. doi: 10.1155/2019/1312804. eCollection 2019.

Authors

Mining Liang^{1

2

3

4}, Beibei Zhang⁵, Lu Deng¹, Rong Xu^{1

6}, Haishan Wu^{2

3

4

7}, Jindong Chen^{2

3

4

7}

Affiliations

¹ Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
² Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
³ Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
⁴ Chinese National Clinical Research Center for Mental Disorder (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
⁵ Brain Hospital of Hunan Province, Changsha, Hunan Province, China.
⁶ Institute of Metabolism and Endocrinology, The Second Xiangya Hospital, Central South University, Changsha, China.
⁷ Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.

Abstract

Aim: To explore whether olanzapine alters bone mineral density (BMD), glucose, and lipid metabolism in schizophrenia patients.

Methods: This study enrolled 150 patients diagnosed with schizophrenia according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), including 101 patients who had over 6-month history of olanzapine use (olanzapine-treated group) and 49 patients who had no history of antipsychotic use (first episode drug-naïve group). 71 subjects with age- and gender-matched healthy volunteers (healthy control group) were also enrolled. All study subjects were from the Chinese Han population recruited in the Second Xiangya Hospital from January 2015 to January 2016. Demographic and physical examination data were collected from all subjects. BMD measurements of the radius+ulna, lumbar spine (L1-4), and left hip were performed via a dual-energy X-ray absorptiometry test. Serum lipid, glucose, and insulin levels were analyzed. Psychopathology profiles in all enrolled schizophrenia patients were assessed by the positive and negative syndrome scale (PANSS).

Results: There was no significant difference in age, gender, activity intensity, smoking, or drinking among the three groups. In the majority of evaluated bone areas, the BMD values in olanzapine-treated or drug-naïve patients were lower than those in the control group. However, BMD values in the drug-naïve group showed no difference or even decreased as compared with those in the olanzapine-treated group. Among the olanzapine-treated group, although not observed in every tested region, a positive correlation was found of BMI or HOMA-IR with BMD. Stepwise multiple linear regression analysis revealed independent predictive factors associated with BMD in groups/subgroups of schizophrenia patients or healthy controls, including gender, TG, BMI, body weight, HOMA-IR, and FBG.

Conclusions: Schizophrenia, but not the long-term use of olanzapine, correlates with BMD loss in schizophrenia patients. Elevated BMI, TG, FBG, and insulin levels might protect these patients against bone degradation. Our work provides new information to improve the understanding, prevention, and treatment of osteoporosis in schizophrenia patients.