Bone mineral density of the proximal femur and lumbar spine in glucocorticoid-treated asthmatic patients
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
The importance of the proximal femur as a site of osteoporotic fractures, the development of techniques for bone mineral density (BMD) measurement at this site and the apparent selectivity of the osteopenic effects of glucorticoids have focused attention on the assessment of proximal femoral BMD in steroid-treated subjects. We have, therefore, measured BMD (Lunar DPX) in the lumbar spine and proximal femur of 31 asthmatic patients receiving long-term glucocorticoid therapy (mean ± SEM dose 16 ± 1 mg prednisone/day, mean duration 10 ± 2 years). BMD values expressed as the percentage of normal age- and sex-appropriate mean values, after weight adjustment, were as follows: lumbar spine 80 ± 2%, femoral neck 83 ± 2%, Ward's triangle 78 ± 3% and trochanter 86 ± 2%. All these values were significantly less than control (p<0.0001) and the decrement in BMD was more marked in Ward's triangle than at the other two femoral sites (p<0.05). In all regions BMD was unrelated to dose or duration of steroid treatment. It is concluded that there are reductions in the BMD of the lumbar spine and proximal femur in glucocorticoid-treated asthmatics, probably reflecting the mixed cortical/trabecular makeup of both regions.
- Cushing H. The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism). Bull Johns Hopkins Hosp 1932; 1: 137–92.
- Curtess PH, Clark WS, Herndon CH. Vertebral fractures resulting from prolonged cortisone and corticotropin therapy. JAMA 1954; 156: 467–9.
- Adinoff AD, Hollister JR. Steroid-induced fractures and bone loss in patients with asthma. N Engl J Med 1983; 309: 265–8.
- Seeman E, Wahner HW, Offord KP, Kumar R, Johnson WJ, Riggs BL. Differential effects of endocrine dysfunction on the axial and the appendicular skeleton. J Clin Invest 1982; 69: 1302–9.
- Hahn TJ, Boisseau VC, Avioli LV. Effect of chronic corticosteroid administration in diaphyseal and metaphyseal bone mass. J Clin Endocrinol Metab 1974; 39: 274–82.
- Reid IR, King AR, Alexander CJ, Ibbertson HK. Prevention of steroid-induced osteoporosis with (3-amino-l-hydroxypropylidene)-l,1-bisphosphonate (APD). Lancet 1988; i: 143–6.
- Sambrook P, Kempler S, Kelly P et al. Coricosteroid effects on proximal femur bone loss. J Bone Miner Res 1990; 5: 1211–16.
- Bohr H, Schaadt O. Bone mineral content of the femoral neck and shaft: relation between cortical and trabecular bone. Calcif Tissue Int 1985; 37: 340–4.
- Schaadt O, Bohr H. Bone mineral in lumbar spine, femoral neck and femoral shaft measured by dual photon absorptiometry with 153-gadolinium in prednisone treatment. Adv Exp Med Biol 1984; 171: 201–8.
- Cooper C, Wickham C. Rheumatoid arthritis; corticosteroid therapy and fracture of the proximal femur. J Bone Miner Res 1990; 5 (Suppl 2): S109 (abst).
- Orwoll ES, Oviatt SK, Mann T. The impact of osteophytic and vascular calcifications on vertebral mineral density measurements in men. J Clin Endocrinol Metab 1990; 70: 1202–7.
- Pocock NA, Eisman JA, Mazess RB, Sambrook PN, Yeates MG, Freund J. Bone mineral density in Australia compared with the United States. J Bone Miner Res 1988; 3: 601–4.
- Nottestad SY, Baumel JJ, Kimmel DB, Recker RR, Heaney RP. The proportion of trabecular bone in human vertebrae. J Bone Miner Res 1987; 2: 221–9.
- Eastell R, Mosekilde LI, Hodgson SF, Riggs BL. Proportion of human vertebral body bone that is cancellous. J Bone Miner Res 1990; 5: 1237–41.
- Reid IR, Heap SW. Determinants of vertebral mineral density in patients receiving long-term glucocorticoid therapy. Arch Intern Med 1990; 150: 2545–8.
- Bone mineral density of the proximal femur and lumbar spine in glucocorticoid-treated asthmatic patients
Volume 2, Issue 2 , pp 103-105
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Bone mineral density
- Industry Sectors