Calcified Tissue International

, Volume 52, Issue 1, pp 5–9

Differential effects of glucocorticoids on cortical appendicular and cortical vertebral bone mineral content

  • R. F. J. M. Laan
  • W. C. A. M. Buijs
  • L. J. Th. O. van Erning
  • J. A. M. Lemmens
  • F. H. M. Corstens
  • S. H. J. Ruijs
  • L. B. A. van de Putte
  • P. L. C. M. van Riel
Clinical Investigation

DOI: 10.1007/BF00675619

Cite this article as:
Laan, R.F.J.M., Buijs, W.C.A.M., van Erning, L.J.T.O. et al. Calcif Tissue Int (1993) 52: 5. doi:10.1007/BF00675619

Summary

The susceptibility to glucocorticoid-induced bone loss may vary in different parts of the skeleton. We studied 62 patients with rheumatoid arthritis, 26 of whom were on low-dose glucocorticoid treatment. Bone mineral content (BMC) in the forearm was measured by single photon absorptiometry at a cortical, diaphyseal, and at a mixed cortical and trabecular, metaphyseal site. Lumbar BMC was measured by dual energy computed tomography in a trabecular and a cortical region of interest. The presence of vertebral deformities was evaluated on lateral spine radiographs. After correction for possibly confounding variables, prednisone therapy significantly influenced BMC at both the trabecular (-22.0%, 95% confidence interval-36.0% to-8.1%) and cortical (-24.8%, 95% confidence interval-39.3% to-10.3%) lumbar site. A significant effect was also seen at the metaphyseal (-15.7%, 95% confidence interval-27.1% to-4.2%), but not the diaphyseal (-3.9%, 95% confidence interval-14.1% to 6.4%) site in the forearm. Correlations between peripheral and vertebral BMC were moderate at best. The diaphyseal to metaphyseal BMC ratio did not identify patients with vertebral osteoporosis. It is concluded that the anterior cortical rim of the vertebral body is more susceptible to the effects of glucocorticoids than the cortical bone in the forearm, and that measurements of trabecular and anterior cortical vertebral BMC are essential in the management of patients with possible glucocorticoid-associated osteoporosis.

Key words

OsteoporosisGlucocorticoidsRheumatoid arthritisQuantitative computed tomographySingle photon absorptiometry

Copyright information

© Springer-Verlag New York Inc. 1993

Authors and Affiliations

  • R. F. J. M. Laan
    • 1
  • W. C. A. M. Buijs
    • 2
  • L. J. Th. O. van Erning
    • 3
  • J. A. M. Lemmens
    • 3
  • F. H. M. Corstens
    • 2
  • S. H. J. Ruijs
    • 3
  • L. B. A. van de Putte
    • 1
  • P. L. C. M. van Riel
    • 1
  1. 1.Department of RheumatologyUniversity Hospital NijmegenNijmegenthe Netherlands
  2. 2.Department of Nuclear MedicineUniversity Hospital NijmegenNijmegenthe Netherlands
  3. 3.Department of RadiologyUniversity Hospital NijmegenNijmegenthe Netherlands