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A meta-analysis of prior corticosteroid use and fracture risk.

Kanis, John A (författare)
Johansson, Helena, 1981 (författare)
University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för samhällsmedicin, Avdelningen för geriatrik,Institute of Community Medicine, Dept of Geriatric Medicine
Odén, Anders, 1942 (författare)
Chalmers University of Technology,University of Gothenburg,Chalmers tekniska högskola,Gothenburg University,Göteborgs universitet,Institutionen för matematisk statistik,Department of Mathematical Statistics
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Johnell, Olof (författare)
Lund University,Lunds universitet,Ortopedi - klinisk och molekylär osteoporosforskning,Forskargrupper vid Lunds universitet,Orthopedics - Clinical and Molecular Osteoporosis Research,Lund University Research Groups
De Laet, Chris (författare)
Melton III, L Joseph (författare)
Tenenhouse, Alan (författare)
Reeve, Jonathan (författare)
Silman, Alan J (författare)
Pols, Huibert A P (författare)
Eisman, John A (författare)
McCloskey, Eugene V (författare)
Mellström, Dan, 1945 (författare)
University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för samhällsmedicin, Avdelningen för geriatrik,Institute of Community Medicine, Dept of Geriatric Medicine
McCloskey, EV (författare)
Silman, AJ (författare)
Oden, A (författare)
Melton, LJ (författare)
Pols, HAP (författare)
Mellstrom, D (författare)
Johansson, H (författare)
Reeve, J (författare)
Kanis, JA (författare)
Tenenhouse, A (författare)
Eisman, JA (författare)
de Laet, C (författare)
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AMBMR, 2004
Ingår i: Journal of bone and mineral research. - : AMBMR. - 0884-0431 .- 1523-4681. ; 19:6, s. 893-9
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
  • The relationship between use of corticosteroids and fracture risk was estimated in a meta-analysis of data from seven cohort studies of approximately 42,000 men and women. Current and past use of corticosteroids was an important predictor of fracture risk that was independent of prior fracture and BMD. INTRODUCTION: The aims of this study were to validate that corticosteroid use is a significant risk factor for fracture in an international setting and to explore the effects of age and sex on this risk. MATERIALS AND METHODS: We studied 42,500 men and women from seven prospectively studied cohorts followed for 176,000 patient-years. The cohorts comprised the EPOS/EVOS study, CaMos, the Rotterdam Study, Dubbo Osteoporosis Epidemiology Study (DOES), and prospective cohorts at Sheffield, Rochester, and Gothenburg. The effect of ever use of corticosteroids, BMD, age, and sex on all fracture, osteoporotic fracture, and hip fracture risk alone was examined using Poisson regression in each cohort and for each sex. The results of the different studies were merged from the weighted beta coefficients. RESULTS: Previous corticosteroid use was associated with a significantly increased risk of any fracture, osteoporotic fracture, and hip fracture when adjusted for BMD. Relative risk of any fracture ranged from 1.98 at the age of 50 years to 1.66 at the age of 85 years. For osteoporotic fracture, the range of relative risk was 2.63-1.71, and for hip fracture 4.42-2.48. The estimate of relative risk was higher at younger ages, but not significantly so. No significant difference in risk was seen between men and women. The risk was marginally and not significantly upwardly adjusted when BMD was excluded from the model. The risk was independent of prior fracture. In the three cohorts that documented current corticosteroid use, BMD was significantly reduced at the femoral neck, but fracture risk was still only partly explained by BMD. CONCLUSION: We conclude that prior and current exposure to corticosteroids confers an increased risk of fracture that is of substantial importance beyond that explained by the measurement of BMD. Its identification on an international basis validates the use of this risk factor in case-finding strategies.


MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper (hsv//swe)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Basic Medicine (hsv//eng)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Orthopedics (hsv//eng)


Adrenal Cortex Hormones
administration & dosage
chemically induced
Middle Aged
Prospective Studies
Risk Factors
fracture risk
fracture threshold

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