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Effects of Systemic Glucocorticoid Use on Fracture Risk: A Population-Based Study.
- Source :
-
Endocrinology and metabolism (Seoul, Korea) [Endocrinol Metab (Seoul)] 2020 Sep; Vol. 35 (3), pp. 562-570. Date of Electronic Publication: 2020 Sep 22. - Publication Year :
- 2020
-
Abstract
- Background: Long-term glucocorticoid use increases fracture risk by reducing bone mass. This study evaluated the relationship between hip and vertebral fractures and the total amount of systematic glucocorticoid use.<br />Methods: We randomly selected 1,896,159 people aged 20 to 100 years who participated in the National Health Checkup program in 2006. The amount of glucocorticoids prescribed was calculated based on the defined daily dose (DDD). The total DDD was obtained by adding oral and parenteral glucocorticoids for 6 months from the index date. Subjects were categorized into four groups according to total glucocorticoid DDDs: non-users (DDDs=0), low users (0&lt; DDDs ≤45), intermediate users (45&lt; DDDs ≤90), and high users (90&lt; DDDs). We followed them for 2 years. A multivariate Cox proportional hazard model was used to evaluate the effects of the total amount of glucocorticoid use on hip and vertebral fractures.<br />Results: Higher glucocorticoid use was associated with a higher risk of vertebral fracture. Relative to non-users, the vertebral fracture risk was 1.39 times higher in the low-user group, 1.94 times higher in the intermediate-user group, and 2.43 times higher in the highuser group. The risk of hip fracture was 1.72 times higher in intermediate users and 3.28 times higher in high users than in non-users.<br />Conclusion: As the amount of glucocorticoid use for 6 months increased, the risk of hip and vertebral fractures became higher. In order to prevent fractures, it is necessary for doctors to evaluate the total amount of glucocorticoid prescribed to the patient and to provide appropriate treatment.
- Subjects :
- Administration, Oral
Adult
Aged
Aged, 80 and over
Bone Density drug effects
Female
Glucocorticoids administration & dosage
Hip Fractures chemically induced
Hip Fractures epidemiology
Hip Fractures physiopathology
Humans
Male
Middle Aged
Osteoporosis chemically induced
Osteoporotic Fractures epidemiology
Osteoporotic Fractures physiopathology
Proportional Hazards Models
Republic of Korea epidemiology
Risk Assessment methods
Risk Factors
Spinal Fractures chemically induced
Spinal Fractures epidemiology
Spinal Fractures physiopathology
Young Adult
Glucocorticoids adverse effects
Osteoporotic Fractures chemically induced
Subjects
Details
- Language :
- English
- ISSN :
- 2093-5978
- Volume :
- 35
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Endocrinology and metabolism (Seoul, Korea)
- Publication Type :
- Academic Journal
- Accession number :
- 32981298
- Full Text :
- https://doi.org/10.3803/EnM.2020.659