17. 增加骨折的風險
IIss TThheerree aa SSaaffee DDoossee??
• U.K. General Research Practice Database
• Steroid users matched by age, gender and clinical
practice to non-users (n = 244,235 in each arm)
• ~60% female, mean age 57 yrs
17
6
Prednisolone <2.5 mg/d
Prednisolone 2.5–7.5 mg
Prednisolone >7.5 mg
Hip Spine
5
4
3
2
1
0
Relative
Risk
van Staa TP. JBMR 2000;15:993
Glucocorticoid-induced osteoporosis is the most common form of secondary osteoporosis and by far the most common form of drug-related osteoporosis in both men and women. There are no boundaries in terms of age, gender or race. All individuals are impacted by chronic glucocorticoid therapy. Certainly individual patients such as frail elderly women who may already osteoporosis may be at a higher risk of fracture in the short term, but even young healthy patients have a negative burden upon their bones when exposed to chronic glucocorticoids. The literature supports historically that up to half the patients on chronic systemic glucocorticoids either had an osteoporotic fracture or another bone complication known as osteonecrosis, which is essentially dead bone often of the hip.
