Chung Cecilia P, Russell Anthony S, Segami Maria I, Ugarte César A
Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada.
Rheumatol Int. 2005 Mar;25(2):114-7. doi: 10.1007/s00296-003-0411-3. Epub 2003 Nov 20.
The aim of this study was to determine the difference between bone mineral density (BMD) of rheumatoid arthritis (RA) patients on low-dose prednisone and matched RA patients without prior systemic corticosteroid therapy.
Ninety patients attending our clinics and receiving 10 mg/day of prednisone or less for at least the previous 3 consecutive months were studied. The control group comprised 90 selected RA patients without corticosteroid therapy matched for age, race, gender, disease duration, use of methotrexate, postmenopause, and Health Assessment Questionnaire score. The BMD was measured using dual X-ray absorptiometry.
Patients on prednisone had lower BMD than controls (0.94 +/- 0.17 vs 0.96 +/- 0.17 for L2-4 and 0.73 +/- 0.14 vs 0.76 +/- 0.16 for femoral neck), but these differences were not statistically significant (P > 0.05). In post hoc analysis, postmenopausal women on prednisone had more bone loss in femoral neck than controls (0.68 +/- 0.13 vs 0.74 +/- 0.15).
Bone mineral density was not significantly reduced by low-dose prednisone in this diverse group of RA patients. A reduction in hip BMD was seen in postmenopausal women on prednisone.
本研究旨在确定低剂量泼尼松治疗的类风湿关节炎(RA)患者与未接受过全身皮质类固醇治疗的匹配RA患者之间骨密度(BMD)的差异。
对至少连续3个月每天服用10毫克或更少泼尼松的90例在我们诊所就诊的患者进行了研究。对照组包括90例未接受皮质类固醇治疗的RA患者,这些患者在年龄、种族、性别、病程、甲氨蝶呤使用情况、绝经后状态和健康评估问卷评分方面进行了匹配。使用双能X线吸收法测量骨密度。
服用泼尼松的患者骨密度低于对照组(L2-4为0.94±0.17 vs 0.96±0.17,股骨颈为0.73±0.14 vs 0.76±0.16),但这些差异无统计学意义(P>0.05)。在事后分析中,服用泼尼松的绝经后女性股骨颈骨丢失比对照组更多(0.68±0.13 vs 0.74±0.15)。
在这组多样化的RA患者中,低剂量泼尼松并未显著降低骨密度。服用泼尼松的绝经后女性髋部骨密度有所降低。