1. Differences in hip quantitative computed tomography (QCT) measurements of bone mineral density and bone strength between glucocorticoid-treated and glucocorticoid-naive postmenopausal women
- Author
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Joyce H. Keyak, Nancy E Lane, Thomas Lang, Loi Do, Kuo Chiang Lian, Gunnard Modin, and Qaisar Rehman
- Subjects
musculoskeletal diseases ,medicine.medical_specialty ,Bone density ,Endocrinology, Diabetes and Metabolism ,Prednisolone ,Osteoporosis ,Finite Element Analysis ,Urology ,Absorptiometry, Photon ,Bone Density ,medicine ,Humans ,Quantitative computed tomography ,Pelvic Bones ,Glucocorticoids ,Femoral neck ,Aged ,Bone mineral ,Aged, 80 and over ,Hip fracture ,Trochanter ,medicine.diagnostic_test ,business.industry ,Hip Fractures ,Estrogen Replacement Therapy ,Age Factors ,Middle Aged ,medicine.disease ,Surgery ,Bone Diseases, Metabolic ,medicine.anatomical_structure ,Cortical bone ,Female ,business ,Epidemiologic Methods ,Tomography, X-Ray Computed - Abstract
Chronic treatment with glucocorticoids (GCs) leads to significant bone loss and increased risk of fractures. In chronically GC-treated patients, hip fracture risk is nearly 50%. The purpose of this investigation was to determine if there are differences in the quantities of trabecular and cortical bone and bone strength of the hip between GC-treated osteoporotic patients and controls. Methods: Study subjects were GC-treated osteoporotic postmenopausal women, and controls were postmenopausal women, recruited for separate clinical trials. Quantitative computed tomography (QCT) and dual-energy X-ray absorptiometry (DXA) of the hip were obtained from all subjects. QCT outcome variables measured included total, cortical, and trabecular BMD of hip subregions (femoral neck and trochanter) and total hip. In addition, finite element modeling (FEM) was performed on a subset of 19 cases and 38 controls, matched on age (± 5 years), weight (± 5 kg), and history of hormone replacement (>1 year use) to assess failure load in stance and fall loading conditions. Generalized linear models were used to adjust the QCT variables for covariates between groups. Multiple regression was performed to identify independent predictors of bone strength from the QCT variables. Results: Compared with controls, GC-treated subjects were significantly (p
- Published
- 2003