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Titolo:
Vertebral fracture risk with long-term corticosteroid therapy - Prevalenceand relation to age, bone density, and corticosteroid use
Autore:
Naganathan, V; Jones, G; Nash, P; Nicholson, G; Eisman, J; Sambrook, PN;
Indirizzi:
Royal N Shore Hosp, Dept Rheumatol, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia Royal N Shore Hosp St Leonards NSW Australia 2065 ds, NSW 2065, Australia Menzies Ctr Populat Hlth Res, Hobart, Tas, Australia Menzies Ctr Populat Hlth Res Hobart Tas Australia Hobart, Tas, Australia Geelong Hosp, Dept Med, Geelong, Vic, Australia Geelong Hosp Geelong Vic Australia sp, Dept Med, Geelong, Vic, Australia St Vincents Hosp, Garvan Inst Med, Dept Med, Bone & Mineral Res Div, Sydney, NSW 2010, Australia St Vincents Hosp Sydney NSW Australia 2010 v, Sydney, NSW 2010, Australia Royal N Shore Hosp, Dept Rheumatol, Inst Bone & Joint Res, Sydney, NSW, Australia Royal N Shore Hosp Sydney NSW Australia oint Res, Sydney, NSW, Australia
Titolo Testata:
ARCHIVES OF INTERNAL MEDICINE
fascicolo: 19, volume: 160, anno: 2000,
pagine: 2917 - 2922
SICI:
0003-9926(20001023)160:19<2917:VFRWLC>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
LOW-DOSE CORTICOSTEROIDS; X-RAY ABSORPTIOMETRY; RHEUMATOID-ARTHRITIS; MINERAL DENSITY; INDUCED OSTEOPOROSIS; POSTMENOPAUSAL WOMEN; FUNCTIONAL-CAPACITY; DISEASE-ACTIVITY; STEROID-THERAPY; MEN;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Naganathan, V Royal N Shore Hosp, Dept Rheumatol, Inst Bone & Joint Res, St Leonards, NSW 2065, Australia Royal N Shore Hosp St Leonards NSW Australia 2065 Australia
Citazione:
V. Naganathan et al., "Vertebral fracture risk with long-term corticosteroid therapy - Prevalenceand relation to age, bone density, and corticosteroid use", ARCH IN MED, 160(19), 2000, pp. 2917-2922

Abstract

Background: Few data are available regarding vertebral fracture risk in patients treated with oral corticosteroids. The aim of this study was to determine the prevalence and the role of risk factors such as age, bone mineraldensity (BMD), and corticosteroid use for vertebral deformity in patients receiving long-term corticosteroid therapy. Methods: Thoracolumbar x-ray films, BMD, and details on corticosteroid usewere obtained on 229 consecutive patients treated with long-term corticosteroid regimens (greater than or equal to6 months of prednisone, greater than or equal to5 mg/d or equivalent) seen at 4 referral centers. Comparisons were made with a population control group of 286 male and female controls not taking corticosteroids (aged greater than or equal to 60 years). Results: Sixty-five patients (28%) had at least 1 vertebral deformity and 25 (11%) had 2 or more vertebral deformities. Older age, independent of BMD, was a significant risk factor for deformity. Patients aged 70 to 79 yearshad a S-fold increased risk of deformity compared with patients younger than 60 years (odds ratio, 5.13; 95% confidence interval, 2.03-13.0). Compared with the population controls, the prevalence of deformities increased to a greater extent with each decade of age in the corticosteroid group (P=.005). Mean lumbar spine and femoral neck BMD Z scores were lower in the steroid-treated patients with deformities compared with the nonsteroid control group with deformities. When the effects of age, sex, body mass index, and duration of corticosteroid use were adjusted for in logistic regression analysis, low BMD was a modest predictor of deformity (for a 1-SD decrease in lumbar spine BMD: odds ratio, 1.31; 95% confidence interval, 1.02-1.68) and for a 1-SD decrease in femoral neck BMD: odds ratio, 1.77; 95% confidence interval, 1.07-2.94). Conclusions: The combination of increasing age and corticosteroid use is associated with a marked increase in the risk of vertebral deformity. Elderly patients commencing long-term corticosteroid therapy should be consideredfor antiosteoporotic therapy independently of their BMD.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 06:38:16