Osteoporosis International

, Volume 20, Issue 11, pp 1889–1894 | Cite as

Bone fragility in male glucocorticoid-induced osteoporosis is not defined by bone mineral density

  • K. Hayashi
  • M. Yamamoto
  • Y. Murakawa
  • M. Yamauchi
  • H. Kaji
  • T. Yamaguchi
  • T. Sugimoto
Original Article

Abstract

Summary

Eighty-seven male Japanese subjects taking prednisolone ≥5 mg for more than 6 months and 132 age- and body mass index (BMI)-matched control subjects were examined. Multiple regression analysis adjusted for age and BMI showed that spinal bone mineral density (BMD) in the prednisolone group was not associated with prevalent vertebral fractures (VFs).

Introduction

Glucocorticoid (GC) treatment is known to increase the risk for bone fractures. However, the association between VFs and BMD in GC-treated male patients remains unclear.

Methods

Eighty-seven male subjects taking prednisolone ≥5 mg for more than 6 months and 132 age- and BMI-matched control subjects were examined using lateral thoracic and lumbar spine radiographs and spine dual energy X-ray absorptiometry.

Results

The presence of GC use was an independent risk factor for VFs adjusted for age and BMI (odds ratio 10.93, P < 0.001). By receiver operating characteristic analysis, the absolute BMD values for detecting VFs were higher and the sensitivity and specificity were lower in the GC group than in the control group (0.936 vs 0.825 g/cm2 and 53.5% vs 74.0%, respectively). Multiple regression analysis adjusted for age and BMI showed that spinal BMD in the GC group was not associated with prevalent VFs, even after adding current and past maximum GC doses as independent variables.

Conclusions

These results show that lumbar BMD values are not associated with prevalent VFs in GC-treated male patients, suggesting that bone fragility in male GC users is affected by bone quality rather than by BMD.

Keywords

Bone mineral density Glucocorticoid Men Osteoporosis Vertebral fractures 

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Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2009

Authors and Affiliations

  • K. Hayashi
    • 1
  • M. Yamamoto
    • 1
  • Y. Murakawa
    • 2
  • M. Yamauchi
    • 1
  • H. Kaji
    • 3
  • T. Yamaguchi
    • 1
  • T. Sugimoto
    • 1
  1. 1.Internal Medicine 1Shimane University Faculty of MedicineIzumoJapan
  2. 2.Internal Medicine 3Shimane University Faculty of MedicineIzumoJapan
  3. 3.Division of Diabetes, Metabolism, and Endocrinology, Department of Internal MedicineKobe University Graduate School of MedicineKobeJapan

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