Bipolar Disorder and Bone Mineral Density Z-Scores in Relation to Clinical Characteristics and Lithium Medication

Abstract

Bipolar disorder is associated with a long range of medical comorbidities, including migraine, diabetes, and cardiovascular disease. Bipolar disorder has also been associated with an increased risk of bone fractures. Osteoporosis is a reduction in bone mineral density, which leads to an increased risk for fragility fractures. Currently there is limited research on the association between bipolar disorder and osteoporosis. We aimed to study the association between high and low bone mineral density in relation to disease and treatment history in a sample of bipolar patients. We found that bipolar patients with high bone mineral density were more often on lithium medication, had a more active lifestyle and expressed lower current disease burden. Low mineral density was not associated with any of the addressed aspects of disease and treatment history. In conclusion our results support that patients on lithium treatment have higher bone mineral density; further studies are needed to address if lithium medication causes an increase in bone mineral density, and lowers the risk of bone fractures in bipolar disorder.

Bone Health in Mood Disorders: A Narrative Review about Clinical and Biological Connections

“…Animal studies have shown that lithium enhances bone formation and fracture healing [109,110]. Recent studies in humans had associated lithium medication, particularly when administered for extended periods, with a higher BMD and a decreased risk of osteoporosis-related fractures [111,112]. The recent longitudinal register-based study conducted by Köhler-Forsberg and colleagues also revealed a cumulative dose-response relationship between lithium treatment and a decrease in the risk of osteoporosis.…”