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KMID : 1141520200350030562
Endocrinology and Metabolism
2020 Volume.35 No. 3 p.562 ~ p.570
Effects of Systemic Glucocorticoid Use on Fracture Risk: A Population-Based Study
Koh Ji-Weon

Kim Jun-Kang
Cho Hye-Min
Ha Yong-Chan
Kim Tae-Young
Lee Young-Kyun
Kim Ha-Young
Jang Sun-Mee
Abstract
Background: Long-term glucocorticoid use increases fracture risk by reducing bone mass. This study evaluated the relationship between hip and vertebral fractures and the total amount of systematic glucocorticoid use.

Methods: We randomly selected 1,896,159 people aged 20 to 100 years who participated in the National Health Checkup program in 2006. The amount of glucocorticoids prescribed was calculated based on the defined daily dose (DDD). The total DDD was obtained by adding oral and parenteral glucocorticoids for 6 months from the index date. Subjects were categorized into four groups according to total glucocorticoid DDDs: non-users (DDDs=0), low users (0< DDDs ¡Â45), intermediate users (45< DDDs ¡Â90), and high users (90< DDDs). We followed them for 2 years. A multivariate Cox proportional hazard model was used to evaluate the effects of the total amount of glucocorticoid use on hip and vertebral fractures.

Results: Higher glucocorticoid use was associated with a higher risk of vertebral fracture. Relative to non-users, the vertebral fracture risk was 1.39 times higher in the low-user group, 1.94 times higher in the intermediate-user group, and 2.43 times higher in the highuser group. The risk of hip fracture was 1.72 times higher in intermediate users and 3.28 times higher in high users than in non-users.

Conclusion: As the amount of glucocorticoid use for 6 months increased, the risk of hip and vertebral fractures became higher. In order to prevent fractures, it is necessary for doctors to evaluate the total amount of glucocorticoid prescribed to the patient and to provide appropriate treatment.
KEYWORD
Glucocorticoids, Fracture, Epidemiologic studies, Osteoporosis
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