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Bone mineral density in subjects using central nervous system-active medications.
Am J Med. 2005 Dec; 118(12):1414.AJ

Abstract

PURPOSE

Decreased bone mineral density defines osteoporosis according to the World Health Organization and is an important predictor of future fractures. The use of several types of central nervous system-active drugs, including benzodiazepines, anticonvulsants, antidepressants, and opioids, have all been associated with increased risk of fracture. However, it is unclear whether such an increase in risk is related to an effect of bone mineral density or to other factors, such as increased risk of falls. We sought to examine the relationship between bone mineral density and the use of benzodiazepines, anticonvulsants, antidepressants, and opioids in a representative US population-based sample.

SUBJECTS AND METHODS

We analyzed data on adults aged 17 years and older from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Total femoral bone mineral density of 7114 male and 7532 female participants was measured by dual-energy x-ray absorptiometry. Multivariable linear regression models were used to quantify the relation between central nervous system medication exposure and total femoral bone mineral density. Models controlled for relevant covariates, including age, sex, and body mass index.

RESULTS

In linear regression models, significantly reduced bone mineral density was found in subjects taking anticonvulsants (0.92 g/cm2; 95% confidence interval [CI]: 0.89 to 0.94) and opioids (0.92 g/cm2; 95% CI: 0.88 to 0.95) compared with nonusers (0.95 g/cm2; 95% CI: 0.95 to 0.95) after adjusting for several potential confounders. The other central nervous system-active drugs--benzodiazepines or antidepressants--were not associated with significantly reduced bone mineral density.

CONCLUSION

In cross-sectional analysis of NHANES III, anticonvulsants and opioids (but not benzodiazepines or antidepressants) were associated with significantly reduced bone mineral density. These findings have implications for fracture-prevention strategies.

Authors+Show Affiliations

Department of Internal Medicine, Teine Keijinkai Hospital, Sapporo, Japan. mitsuyos220@worldnet.att.netNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16378792

Citation

Kinjo, Mitsuyo, et al. "Bone Mineral Density in Subjects Using Central Nervous System-active Medications." The American Journal of Medicine, vol. 118, no. 12, 2005, p. 1414.
Kinjo M, Setoguchi S, Schneeweiss S, et al. Bone mineral density in subjects using central nervous system-active medications. Am J Med. 2005;118(12):1414.
Kinjo, M., Setoguchi, S., Schneeweiss, S., & Solomon, D. H. (2005). Bone mineral density in subjects using central nervous system-active medications. The American Journal of Medicine, 118(12), 1414.
Kinjo M, et al. Bone Mineral Density in Subjects Using Central Nervous System-active Medications. Am J Med. 2005;118(12):1414. PubMed PMID: 16378792.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone mineral density in subjects using central nervous system-active medications. AU - Kinjo,Mitsuyo, AU - Setoguchi,Soko, AU - Schneeweiss,Sebastian, AU - Solomon,Daniel H, PY - 2004/12/31/received PY - 2005/07/12/accepted PY - 2005/12/28/pubmed PY - 2006/2/25/medline PY - 2005/12/28/entrez SP - 1414 EP - 1414 JF - The American journal of medicine JO - Am. J. Med. VL - 118 IS - 12 N2 - PURPOSE: Decreased bone mineral density defines osteoporosis according to the World Health Organization and is an important predictor of future fractures. The use of several types of central nervous system-active drugs, including benzodiazepines, anticonvulsants, antidepressants, and opioids, have all been associated with increased risk of fracture. However, it is unclear whether such an increase in risk is related to an effect of bone mineral density or to other factors, such as increased risk of falls. We sought to examine the relationship between bone mineral density and the use of benzodiazepines, anticonvulsants, antidepressants, and opioids in a representative US population-based sample. SUBJECTS AND METHODS: We analyzed data on adults aged 17 years and older from the Third National Health and Nutrition Examination Survey (NHANES III, 1988-1994). Total femoral bone mineral density of 7114 male and 7532 female participants was measured by dual-energy x-ray absorptiometry. Multivariable linear regression models were used to quantify the relation between central nervous system medication exposure and total femoral bone mineral density. Models controlled for relevant covariates, including age, sex, and body mass index. RESULTS: In linear regression models, significantly reduced bone mineral density was found in subjects taking anticonvulsants (0.92 g/cm2; 95% confidence interval [CI]: 0.89 to 0.94) and opioids (0.92 g/cm2; 95% CI: 0.88 to 0.95) compared with nonusers (0.95 g/cm2; 95% CI: 0.95 to 0.95) after adjusting for several potential confounders. The other central nervous system-active drugs--benzodiazepines or antidepressants--were not associated with significantly reduced bone mineral density. CONCLUSION: In cross-sectional analysis of NHANES III, anticonvulsants and opioids (but not benzodiazepines or antidepressants) were associated with significantly reduced bone mineral density. These findings have implications for fracture-prevention strategies. SN - 1555-7162 UR - https://www.unboundmedicine.com/medline/citation/16378792/Bone_mineral_density_in_subjects_using_central_nervous_system_active_medications_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(05)00627-3 DB - PRIME DP - Unbound Medicine ER -