Abstract
BackgroundGlucocorticoid-induced osteoporosis and vertebral fracture are common complications in patients on glucocorticoid treatment for rheumatological diseases. The present study aimed to identify the risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis.MethodsThis study included 225 Japanese women with glucocorticoid-induced osteoporosis and 72 patients with postmenopausal osteoporosis. All participants were treated with bisphosphonate or denosumab for osteoporosis with active form of vitamin D for at least 3 years. The differences of clinical parameters, including age, disease duration, body mass index (BMI), bone mineral density (BMD), and the dose and treatment duration of glucocorticoid were assessed between patients with and without vertebral fracture. Multivariate logistic regression analysis was also performed to evaluate the association of vertebral fracture with clinical parameters.ResultsThe significant differences related to age, BMD of the hip, disease duration, glucocorticoid treatment duration between patients with and without vertebral fractures were demonstrated. The present study indicated that disease duration, BMI, and the total hip BMD were independent risk factors for vertebral fractures in patients with glucocorticoid-induced osteoporosis.ConclusionsProlonged disease duration, low BMI, and low total hip BMD could be risk factors of vertebral fracture in patients on glucocorticoid treatment for rheumatological diseases.
Highlights
Glucocorticoid is still used for the treatment of rheumatological diseases despite the development of targeted treatment agents [1]
The glucocorticoid group had a lower average age and higher height and body weight compared with the postmenopausal osteoporosis group
All parameters of bone mineral density (BMD) were significantly higher in the glucocorticoidinduced osteoporosis group [lumbar spine: 0.775 (0.118) vs. 0.884 (0.13) g/cm2, respectively, p < 0.0001; femoral neck: 0.541 (0.12) vs. 0.654 (0.118) g/cm2, p < 0.0001; Table 1 Clinical characteristics of patients with postmenopausal osteoporosis and glucocorticoid-induced osteoporosis
Summary
Glucocorticoid is still used for the treatment of rheumatological diseases despite the development of targeted treatment agents [1]. Previous studies have reported that the fracture risk of patients on glucocorticoid was related to the dose and duration of glucocorticoid treatment [2, 8, 10]. The association of glucocorticoid exposure with bone loss and fracture risk remains unclear [7, 10]. Several studies on glucocorticoid-induced osteoporosis have failed to identify the correlation between glucocorticoid dose and bone loss [12, 13]. The reason for the increased bone fragility of glucocorticoid users remains unclear. Glucocorticoid-induced osteoporosis and vertebral fracture are common complications in patients on glucocorticoid treatment for rheumatological diseases. The present study aimed to identify the risk factors of vertebral fracture in Japanese female patients with glucocorticoid-induced osteoporosis
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