Vertebral fracture risk in glucocorticoid-induced osteoporosis: the role of hypogonadism and corticosteroid boluses
| Autor: | José A. Gómez-Puerta, Josep L. Carrasco, Maria C. Cid, Gerard Espinosa, Núria Guañabens, Pilar Peris, Silvia Ruiz-Gaspà, Helena Florez, José Hernández-Rodríguez, Africa Muxi, Sergio Prieto-González, Xavier Filella, Ana Monegal |
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| Rok vydání: | 2020 |
| Předmět: |
Male
FRAX Bone density Osteoporosis Gastroenterology Bone remodeling 0302 clinical medicine Absorptiometry Photon Adrenal Cortex Hormones Bone Density Risk Factors Immunology and Allergy Aged 80 and over Middle Aged Corticosteroid Spinal Fractures Female Disease Susceptibility Glucocorticoid medicine.drug Adult medicine.medical_specialty Adolescent medicine.drug_class Immunology 030209 endocrinology & metabolism Risk Assessment Autoimmune Diseases 03 medical and health sciences Young Adult Trabecular bone score Sex Factors Rheumatology Densitat mineral òssia Internal medicine Rheumatic Diseases medicine Humans Risk factor Glucocorticoides Glucocorticoids Aged 030203 arthritis & rheumatology business.industry Hypogonadism Osteoporosi medicine.disease Cross-Sectional Studies business Fractures Biomarkers Osteoporotic Fractures |
| Zdroj: | RMD Open Dipòsit Digital de la UB Universidad de Barcelona |
| ISSN: | 2056-5933 |
| Popis: | ObjectiveThe aim of this study was to identify the risk factors associated with fragility fracture (FF) development in glucocorticoid (GC)-treated patients.Methods127 patients (aged 62±18 years, 63% women) on GC-treatment (mean dose 14.5±14.1 mg/day and duration 47.7±69 months) were included. The clinical data collected included bone metabolism study (including gonadal axis), GC-treatment, disease activity, dual-energy X-ray absorptiometry analysis (evaluating densitometric osteoporosis (OP) and trabecular bone score (TBS) degraded microarchitecture values (DMA)), X-ray (assessing vertebral fractures (VF)), FRAX risk (GC-adjusted) and previous FF.Results17% of the patients had VF, 28% FF (VF and/or non-VF), 29% OP and 52% DMA. Patients with VF received more GC boluses (57.1% vs 29.5%, p=0.03), were older (68±13 vs 60±19 years, p=0.02), postmenopausal (100% vs 67%, p=0.02), had low testosterone levels (57% vs 11%, p=0.02), lower TBS values (1.119±0.03 vs 1.237±0.013, p100, p=0.01) and having received GC boluses (OR 3.45; 95% CI 1.04 to 12.15, p=0.01) were the main factors related to VF. Hypogonadism (OR 7.03; 95% CI 1.47 to 38.37, p=0.01) and FRAX >20 (OR 7.08; 95% CI 1.28 to 53.71, p=0.02) were factors related to FF.ConclusionHypogonadism is the principal risk factor for developing fractures in GC-treated men and women, whereas receiving GC boluses is a major factor for VF. These results indicate the importance of evaluating the gonadal axis in these patients. |
| Databáze: | OpenAIRE |
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