Dejstvo antidepresiva na serumske koncentracije markera metabolizma kosti i glavnih elektrolita kod bolesnika u rutinskoj psihijatrijskoj praksi

  • Nikola Riznić Serbian Armed Forces, Institute of Aviation Medicine, Belgrade, Serbia
  • Dragan R. Milovanović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Department of Clinical Pharmacology.
  • Slavica Djukić Dejanović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Psychiatry.
  • Slobodan M. Janković University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Department of Clinical Pharmacology.
  • Dragan Ravanić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Psychiatry.
  • Dragana Ignjatović Ristić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Psychiatry.
  • Dušan Petrović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Psychiatry.
  • Mirjana Jovanović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Psychiatry.
  • Violeta Mladenović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Internal Medicine, Kragujevac, Serbia
  • Dejana Ružić Zečević University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
  • Vladimir Janjić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia; Clinical Center “Kragujevac”, Clinic of Psychiatry.
DOI: https://doi.org/10.2298/VSP150828084R
Ključne reči: antidepressive agents||, ||antidepresivi, bone and bones||, ||kost, metabolism||, ||metabolizam, electrolytes||, ||elektroliti, risk assessment||, ||rizik, procena, clinical chemistry tests||, ||hemija, klinička, testovi,

Sažetak


Uvod/Cilj. Nema dovoljno podataka o uticaju antidepresiva na metabolizam kalcijuma, fosfora i magnezijuma. Cilj rada bio je da se istraže efekti antidepresiva na serumsku koncentraciju markera metabolizma kosti i glavnih elektrolita kod bolesnika u psihijatrijskoj praksi. Metode. U prospektivnu studiju, dizajna vremenske serije pre i posle, bio je uključeno 9 muškaraca i 24 žene, prosečne starosti 53,3 ± 11,5 godina, koji su bolovali od depresije n = 26 i neurotičnih poremećaja n = 7 i koji su uglavnom lečeni selektivnim inhibitorima preuzimanja serotonina. Određivani su analiti na početku, u 4, 6. i 12. nedelje lečenja i analizirane promene parametara i trendovi u odnosu na početne vrednosti uz statističku značajnost od p ≤ 0,05. Rezultati. Utvrđeno je da starost iznad 60 godina predstavlja značajan faktor rizika od pojave negativnih kumulativnih promena (u procentima) u odnosu na bazalne koncentracije 25-hidroksivitamina D – 25(OH)D (OR = 11,4, 95% CI 1,2–113,1, p = 0,037). Koncentracije kalcijuma u serumu značajno su korelisale sa koncentracijama natrijuma (rs = 0,531, p < 0,001), hlorida (r = 0,496, p < 0,001), magnezijuma (rs = 0,402, p < 0.001 i osteokalcina r = 0,240, p = 0,019. Značajne korelacije nađene su između koncentracija fosfora i hlorida (r = -0,218, p = 0,035); magnezijuma i natrijuma (r = 0,295, p = 0,004) i kalijuma (r = 0,273, p = 0,009); osteokalcina i C-telopeptida (r = 0,760, p < 0,001), natrijuma (r = 0,215, p = 0,039) i hlorida (r = 0,209, p = 0,041); natrijuma i hlorida (r = 0,722, p < 0,001). Nije utvrđena statistički značajna razlika između terapije antidepresivima i promena apsolutnih vrednosti serumskih koncentracija kalcijuma, magnezijuma, fosfora, 25 OH D, osteokalcina, C-telopeptida, natrijuma, kalijuma i hlorida. Takođe nisu utvrđene statistički značajne razlike ni u učestalosti poremećaja i vrednostima laboratorijskih analita (ispod/iznad donje/gornje granice referentnih vrednosti. Zaključak. Lečenje antidepresivima nije značajno povezano sa promenama studijskih analita ali neki od njih su međusobno bili u pozitivnoj korelaciji, što sugeriše potrebu individualnog pristupa bolesniku i daljih istraživanja u oblasti kosti metabolizma kod osoba sa mentalnim poremećajima.

 

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Objavljeno
2017/07/07
Broj časopisa
Vol. 74 Br. 7 (2017)
Rubrika
Originalni članak