Background
This study was designed to test the hypothesis that cortisol mediates the relationship
between bone density and depression in postmenopausal women.
Methods
Nineteen women aged 52–79 who had been assessed for bone mineral density by dual-energy
x-ray absorptiometer (DEXA) were evaluated for depression and anxiety. Diurnal and
stress-induced measures of salivary cortisol were obtained during the following week
and at a laboratory session involving a speech task.
Results
Nine volunteers reported depression while 10 were never depressed. Ever depressed
women had significantly lower total lumbar and right femur DEXA Z scores than never
depressed (t(17) = 2.5, p = .019 and t(17) = 2.06, p = .05, respectively). Ever depressed women demonstrated a significant increase in
salivary cortisol (area under the curve (AUC) = 27.83, SD = 37.64) compared to never
depressed women (AUC = -13.34, SD = 19.55) (t(17) = -3.041, p = .007) during a psychological challenge. There were significant inverse relationships
between salivary cortisol AUC values and bone density Z scores at every measured bone site. Mediation analyses suggest that 51 – 67% of the
association between depression and bone density could be attributed to stress-induced
changes in cortisol.
Conclusions
Cortisol hypersecretion in response to stress may, in part, explain the impact of
depression on bone density in post-menopausal women.
Key words
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Article info
Publication history
Published online: March 10, 2005
Accepted:
December 20,
2004
Received in revised form:
December 9,
2004
Received:
July 29,
2004
Identification
Copyright
© 2005 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.