Vinoomika Chandrasekaran1, Julie A Pasco2,3,4,5, Amanda L Stuart2, Sharon L Brennan-Olsen4,6,7,8, Michael Berk2,3,5,9,10,11, Jason M Hodge2,3,12, Rasika M Samarasinghe2, Lana J Williams2. 1. IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia. vchand@deakin.edu.au. 2. IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, PO Box 281, Barwon Health, Geelong, Vic, 3220, Australia. 3. Barwon Health, University Hospital, Geelong, Australia. 4. Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia. 5. Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia. 6. Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, St Albans, Australia. 7. Deakin University, School of Health and Social Development, Geelong, Waterfront, Australia. 8. Institute for Health Transformation, Deakin University, Burwood, Australia. 9. Department of Psychiatry, University of Melbourne, Parkville, Australia. 10. Florey Institute of Neuroscience and Mental Health, Parkville, Australia. 11. Orygen the National Centre of Excellence in Youth Mental Health, Parkville, Australia. 12. Geelong Centre for Emerging Infectious Diseases, Geelong, Australia.
Abstract
BACKGROUND: Anticonvulsant use has been linked to bone deficits in specific patient populations. We studied the association between anticonvulsant use and bone health in a population-based sample of men and women. METHODS: Data from 926 men (24-73 yr) and 1070 women (21-94 yr) participating in the Geelong Osteoporosis Study were included. Bone mineral density (BMD, g/cm2) of the PA-spine and total hip was measured using dual-energy X-ray absorptiometry (Lunar). Bone quality was determined using quantitative heel ultrasound (QUS). Anthropometry was conducted and socioeconomic status was determined. Medication and lifestyle information was obtained via questionnaire. Linear regression was used to test associations between anticonvulsant use and bone health before and after adjustment for potential confounders. RESULTS: Seventeen (1.8%) men and 20 (1.9%) women reported anticonvulsant use. In men, anticonvulsant users had 9.1% lower adjusted mean BMD at the spine and hip compared to non-users. Body mass index was an effect modifier at the spine. Anticonvulsant users also had 1.8% lower speed of sound (SOS), 10.6% lower broadband ultrasound attenuation (BUA) and 13.7% lower stiffness index (SI) compared to non-users. In women, BMD tended to be lower at the hip compared to non-users as with the bone quality measure, BUA. No significant associations were observed at the spine or the other bone quality measures, SOS and SI. CONCLUSION: Our data suggest that bone quantity and quality, assessed using BMD and QUS, are lower for men and possibly women who use anticonvulsants. While further exploration into potential mechanisms is needed, our findings suggest that monitoring bone health among users of anticonvulsants is warranted.
BACKGROUND: Anticonvulsant use has been linked to bone deficits in specific patient populations. We studied the association between anticonvulsant use and bone health in a population-based sample of men and women. METHODS: Data from 926 men (24-73 yr) and 1070 women (21-94 yr) participating in the Geelong Osteoporosis Study were included. Bone mineral density (BMD, g/cm2) of the PA-spine and total hip was measured using dual-energy X-ray absorptiometry (Lunar). Bone quality was determined using quantitative heel ultrasound (QUS). Anthropometry was conducted and socioeconomic status was determined. Medication and lifestyle information was obtained via questionnaire. Linear regression was used to test associations between anticonvulsant use and bone health before and after adjustment for potential confounders. RESULTS: Seventeen (1.8%) men and 20 (1.9%) women reported anticonvulsant use. In men, anticonvulsant users had 9.1% lower adjusted mean BMD at the spine and hip compared to non-users. Body mass index was an effect modifier at the spine. Anticonvulsant users also had 1.8% lower speed of sound (SOS), 10.6% lower broadband ultrasound attenuation (BUA) and 13.7% lower stiffness index (SI) compared to non-users. In women, BMD tended to be lower at the hip compared to non-users as with the bone quality measure, BUA. No significant associations were observed at the spine or the other bone quality measures, SOS and SI. CONCLUSION: Our data suggest that bone quantity and quality, assessed using BMD and QUS, are lower for men and possibly women who use anticonvulsants. While further exploration into potential mechanisms is needed, our findings suggest that monitoring bone health among users of anticonvulsants is warranted.
Entities:
Keywords:
Anticonvulsants; Bone mineral density; Osteoporosis, psychiatry, neuroscience, medical comorbidity; Quantitative heel ultrasound