![]() Thus far, the evidence of the relationship between schizophrenia and fracture mainly comes from the relevant research or clinical observation, and the confusion triggered by intermediary factors and possible reverse causal relationship hinders the exploration of causal effect. Therefore, the causal association of schizophrenia with fracture and osteoporosis should be worth investigating. In patients with schizophrenia, other risk factors for osteoporosis and fractures such as lack of physical activity, diabetes, smoking, excessive drinking and vitamin D deficiency are more prevalent, which may further contribute to the occurrence and development of schizophrenia. Previous studies have reported that hyperprolactinemia caused by the long-term use of antipsychotics accelerates bone turnover, which results in hypothalamic-pituitary-gonadal axis mediating osteopenia so as to increase the risk of fracture. ![]() However, the pathogenesis of osteoporosis and fracture in patients with schizophrenia are not clearly defined. Compared with the general population, patients with schizophrenia experience poor general health outcomes, including increased risks of osteoporosis which is characterized by abnormally low bone mineral density (BMD), and fracture, especially hip fracture. Schizophrenia is a severe, complex and neuropsychiatric disorder with marked functional impairment posing a considerable societal burden, affecting about 1% of the world’s population. The current finding confirmed that schizophrenia was causally associated with the fractures of skull, face and femur as well as eBMD, which might remind psychiatrists to pay close attention to the fracture risk in schizophrenic patients when formulating their treatment strategies. However, no causal effect of schizophrenia on fracture or BMD in other parts was detected. Sensitivity analyses showed similar results. These causal effects still existed after adjusting for BMI. Result from inverse variance weighting (IVW) method provided evidence schizophrenia increased the risk of fractures of skull and facial bones and femur, whereas, decreased the level of eBMD. Multivariable Mendelian randomization (MVMR) analysis was performed to minimize the confounding effect of body mass index (BMI). Two-sample MR was utilized, based on instrumental variables from large genome-wide association studies (GWAS) of schizophrenia as exposure, to identify the causal association of schizophrenia with mixed fractures, fractures at different body sites (including skull and facial bones, shoulder and upper arm, wrist and hand, and femur) and BMDs of forearm (FA), femoral neck (FN), lumbar spine (LS) and estimated BMD (eBMD). This study aimed to test the causal effects between schizophrenia and fractures as well as aberrant BMD by conducting Mendelian randomization (MR) analyses. Burns remained owner and CEO as of 2003 and an outspoken advocate of community journalism.Schizophrenia was clinically documented to co-occur with fractures and aberrant bone mineral density (BMD), but the potential causal relationship remained unclear. Mundy’s widow Eleanor Mundy took over the paper in 1982 and left it to her daughter Judith Mundy Burns in 1998. Under this agreement, control of the paper first devolved to Chaffin and Mundy and then to Mundy alone. The three agreed that the survivors would have the opportunity to purchase the shares of any partner who died. Often working from Sunnyside, his residence on Taggart Avenue in Greenwood, Watson composed daily editorials and became well known as a community leader.Īfter Watson’s death, the Index-Journal passed to three of its executives: circulation manager Frank Mundy, advertising manager Bill Wilson, and editor Ed Chaffin. After an initial career as a lawyer, Harry Legare Watson (1876–1956) of Phoenix, South Carolina, merged the two papers in 1919 and continued as owner and editor for the rest of his life. The Greenwood Journal became the Greenwood Daily Journal in 1911. The Greenwood Journal began in 1894 while its rival the Index commenced three years later in 1897. The Index-Journal is one of the last family-owned daily newspapers in the state. It now serves the Lakelands area, including Greenwood, Abbeville, McCormick, and Saluda Counties. A daily newspaper published in Greenwood, the Index-Journal was founded in 1919 with the merger of two earlier papers, the Greenwood Evening Index and the Greenwood Daily Journal.
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