The impact of oral corticosteroid use on bone mineral density and vertebral fracture

Walsh, Lesley J., Lewis, Sarah A., Wong, Conroy A., Cooper, Susan, Oborne, Janet, Cawte, Susan A., Harrison, Timothy, Green, Desmond J., Pringle, Michael, Hubbard, Richard and Tattersfield, Anne E. (2002) The impact of oral corticosteroid use on bone mineral density and vertebral fracture. American Journal of Respiratory and Critical Care Medicine, 166 5: 691-695. doi:10.1164/rccm.2110047


Author Walsh, Lesley J.
Lewis, Sarah A.
Wong, Conroy A.
Cooper, Susan
Oborne, Janet
Cawte, Susan A.
Harrison, Timothy
Green, Desmond J.
Pringle, Michael
Hubbard, Richard
Tattersfield, Anne E.
Title The impact of oral corticosteroid use on bone mineral density and vertebral fracture
Journal name American Journal of Respiratory and Critical Care Medicine   Check publisher's open access policy
ISSN 1073-449X
Publication date 2002
Sub-type Article (original research)
DOI 10.1164/rccm.2110047
Volume 166
Issue 5
Start page 691
End page 695
Total pages 5
Place of publication New York
Publisher American Thoracic Society
Language eng
Abstract The use of oral corticosteroids is associated with an increased risk of fracture, but there is limited information on the relationship between corticosteroid dose, bone mineral density (BMD), and fracture. We examined this relationship in a community population (more than 50 years) taking oral corticosteroids for chronic lung disease. Details of corticosteroid use and lifestyle were obtained by questionnaire, general practice records, and patient interview. BMD was assessed at the lumbar spine and femur and vertebral fracture by morphometric X-ray absorptiometry. Of the 117 patients who participated (median age, 69), 48% were female. Fifty-eight percent had osteoporosis (a T score of less than -2.5), and 61% had a vertebral fracture. The presence of vertebral fracture was related to BMD at the femoral neck, with an odds ratio of 1.6 for a 1 SD reduction in BMD. The cumulative prednisolone dose ranged from 3.4 to 175 g and was strongly associated with vertebral fracture, with the odds ratio between the highest and lowest dose quartiles being 4.4 (95% confidence interval, 1.04, 18.8). The difference in femoral neck BMD between the same dose quartiles was only modest, however (0.5 SD; 95% confidence interval, 0.09, 0.94). In patients taking long-term oral corticosteroids for chronic lung disease, the relationship between vertebral fracture risk and BMD is similar to that seen in other populations. Cumulative prednisolone dose is strongly related to fracture risk, and this effect is independent of its more modest impact on BMD.
Keyword Critical Care Medicine
Respiratory System
Corticosteroids
Bone
Dose-related effects
Fracture
Rheumatoid-arthritis
Asthma
Osteoporosis
Deformities
Therapy
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Dentistry Publications
 
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Created: Wed, 17 Oct 2007, 11:31:02 EST