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KMID : 1007020030010020121
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Korean Soceity of Osteroporosis
2003 Volume.1 No. 2 p.121 ~ p.129
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Impacting Factors on Bone Mineral Density in Korean Postmenopausal Women with latrogenic Cushing’s Syndrome
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Shin Young-Goo
Lee Yeon
Lee Byung-Jun
Koh Jang-Hyun
Chung Choon-Hee
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Abstract
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Objectives: Glucocorticoid (GC) is one of the most common cause in the drug induced osteoporosis. We evaluated the impacting effects of chronic GC use on bone mineral density (BMD) and some factors influencing to BMD.
Methods: Thirteen postmenopausal women with iatrogenic Cushing`s syndrome (ICS) who visited Wonju Christian Hospital during one year were evaluated on their BMDs of spine and right femur. Thirty four postmenopausal women without drug history of GC were grouped as control. Both groups had not any other disease or drugs influencing to BMD. Diagnosis of ICS was confirmed by rapid ACTH stimulation test. BMD, total body fat and lean body mass were measured by DEXA. Twenty four hours urinary deoxypyridinoline (Dpd) was measured by ELISA, osteocalcin by RIA. We had asked some questions to all subjects including the history of obstetrics and GC use. To compare BMD in the both groups, we analysed BMD by independent t test, and then used multiple regression analysis after adjustment with age and body mass index. To clarify impacting factors on BMD in patients with ICS, we evaluated the relation between BMD and possible impacting factors by bivariate correlation, and then analysed by partial correlation after adjustment with compounding factors.
Results: After adjustment with age and body mass index, there was still remained lower BMD of femoral ward’s in ICS. In ICS, age was negatively related to the BMD of spine and femur. After adjustment with age, the age at the beginning of GC was still negatively related to the BMD of second and fourth lumbar vertebrae. Also age at menarche was still negatively related to BMD of femoral trochanter.
Conclusion: Chronic GC use was causing the loss of BMD, especially, in the femoral neck. Age was the most influencing factor in the loss of BMD in ICS and followed by age at the beginning of GC and age at menarche. With aging, the loss of BMD would be accelerated by GC use.
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KEYWORD
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Glucocorticoid use, Bone Mineral Density, Postmenopausal
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