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Published in: Archives of Osteoporosis 1/2017

01-12-2017 | Original Article

Prevalence and risk factors associated with glucocorticoid-induced osteoporosis in Chinese patients with rheumatoid arthritis

Authors: Can-chen Ma, Sheng-qian Xu, Xun Gong, Ying Wu, Shan Qi, Wen Liu, Jian-hua Xu

Published in: Archives of Osteoporosis | Issue 1/2017

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Abstract

Summary

Usage of glucocorticoid (GC) is a strong risk factor of osteoporosis (OP) and osteoporotic fracture (OPF) in Chinese patients with rheumatoid arthritis (RA). Controlling GC daily dosage and shortening GC course are helpful in preventing glucocorticoid-induced osteoporosis (GIOP) and OPF for Chinese patients with RA.

Introduction

This study aims to investigate the prevalence and risk factors of GIOP, and also identify influences of GC daily dosage and GC treatment course for GIOP in Chinese patients with RA.

Methods

Seven hundred and ninety patients with RA and 158 normal subjects were enrolled in the study. Clinical and laboratory features and medications of GC were recorded in detail. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry in all subjects.

Results

BMD at all measured sites in RA was significantly lower than that in control group. Prevalence of OP was obviously higher in RA with GC group (41.6%), compared with RA without GC group (29.4%). Prevalence of OPF in group of RA with GC (21.0%) was higher than that in group of RA without GC (13.3%). Usage of GC, female, and age were risk factors for the occurrence of OP and OPF in RA, while body mass index (BMI) was the protective factor of OP. Prevalence of GIOP and OPF had statistical significance among groups of different treatment courses with GC, whereas no statistical difference was found among groups with different daily dosages of GC.

Conclusions

GIOP exists generally in Chinese patients with RA, which relates to treatment course not daily dosage of GC. Usage of GC is also the risk factor for the happening of OPF in Chinese patients with RA.
Literature
2.
go back to reference Ghafoori S, Keshtkar A, Khashayar P et al (2014) The risk of osteoporotic fractures and its associating risk factors according to the FRAX model in the Iranian patients: a follow-up cohort. J Diabetes Metab Disord 13:2–4. doi:10.1186/s40200-014-0093-2 CrossRef Ghafoori S, Keshtkar A, Khashayar P et al (2014) The risk of osteoporotic fractures and its associating risk factors according to the FRAX model in the Iranian patients: a follow-up cohort. J Diabetes Metab Disord 13:2–4. doi:10.​1186/​s40200-014-0093-2 CrossRef
3.
go back to reference Ghazi M, Kolta S, Briot K et al (2012) Prevalence of vertebral fractures in patients with rheumatoid arthritis: revisiting the role of glucocorticoids. Osteoporosis Int 23:581–587. doi:10.1007/s00198-011-1584-3 CrossRef Ghazi M, Kolta S, Briot K et al (2012) Prevalence of vertebral fractures in patients with rheumatoid arthritis: revisiting the role of glucocorticoids. Osteoporosis Int 23:581–587. doi:10.​1007/​s00198-011-1584-3 CrossRef
11.
go back to reference Vosse D, De VK (2009) Osteoporosis in rheumatoid arthritis and ankylosing spondylitis. Clin Exp Rheumatol 27:62–67 Vosse D, De VK (2009) Osteoporosis in rheumatoid arthritis and ankylosing spondylitis. Clin Exp Rheumatol 27:62–67
13.
go back to reference Li H, Qian W, Weng X et al (2012) Glucocorticoid receptor and sequential P53 activation by dexamethasone mediates apoptosis and cell cycle arrest of osteoblastic MC3T3-E1 cells. PLoS One 7:1–8. doi:10.1371/journal.pone.0037030 Li H, Qian W, Weng X et al (2012) Glucocorticoid receptor and sequential P53 activation by dexamethasone mediates apoptosis and cell cycle arrest of osteoblastic MC3T3-E1 cells. PLoS One 7:1–8. doi:10.​1371/​journal.​pone.​0037030
16.
go back to reference Solomon DH, Katz JN, Jacobs JP et al (2002) Management of glucocorticoid-induced osteoporosis in patients with rheumatoid arthritis: rates and predictors of care in an academic rheumatology practice. Arthritis Rheumatol 46:3136–3142. doi:10.1002/art.10613 CrossRef Solomon DH, Katz JN, Jacobs JP et al (2002) Management of glucocorticoid-induced osteoporosis in patients with rheumatoid arthritis: rates and predictors of care in an academic rheumatology practice. Arthritis Rheumatol 46:3136–3142. doi:10.​1002/​art.​10613 CrossRef
17.
go back to reference Mikuls TR, Saag KG, Curtis J et al (2005) Prevalence of osteoporosis and osteopenia among African Americans with early rheumatoid arthritis: the impact of ethnic-specific normative data. J Natl Med Assoc 97:1155–1160PubMedPubMedCentral Mikuls TR, Saag KG, Curtis J et al (2005) Prevalence of osteoporosis and osteopenia among African Americans with early rheumatoid arthritis: the impact of ethnic-specific normative data. J Natl Med Assoc 97:1155–1160PubMedPubMedCentral
21.
23.
go back to reference Siris ES, Gehlbach S, Adachi JD et al (2011) Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporosis Int 22:27–35. doi:10.1007/s00198-010-1211-8 CrossRef Siris ES, Gehlbach S, Adachi JD et al (2011) Failure to perceive increased risk of fracture in women 55 years and older: the Global Longitudinal Study of Osteoporosis in Women (GLOW). Osteoporosis Int 22:27–35. doi:10.​1007/​s00198-010-1211-8 CrossRef
25.
go back to reference Maruotti N, Corrado A, Cantatore FP (2010) Glucocorticoid induced risk of fractures. Panminerva Med 52:339–343PubMed Maruotti N, Corrado A, Cantatore FP (2010) Glucocorticoid induced risk of fractures. Panminerva Med 52:339–343PubMed
26.
go back to reference Grossman JM, Gordon R, Ranganath VK et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthrit Care Res 62:1515–1526. doi:10.1002/acr.20295 CrossRef Grossman JM, Gordon R, Ranganath VK et al (2010) American College of Rheumatology 2010 recommendations for the prevention and treatment of glucocorticoid-induced osteoporosis. Arthrit Care Res 62:1515–1526. doi:10.​1002/​acr.​20295 CrossRef
Metadata
Title
Prevalence and risk factors associated with glucocorticoid-induced osteoporosis in Chinese patients with rheumatoid arthritis
Authors
Can-chen Ma
Sheng-qian Xu
Xun Gong
Ying Wu
Shan Qi
Wen Liu
Jian-hua Xu
Publication date
01-12-2017
Publisher
Springer London
Published in
Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI
https://doi.org/10.1007/s11657-017-0329-0

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