Weatherall M, James K, Clay J, Perrin K, Masoli M, Wijesinghe M, Beasley R
University of Otago Wellington, Wellington, New Zealand.
Clin Exp Allergy. 2008 Sep;38(9):1451-8. doi: 10.1111/j.1365-2222.2008.03029.x. Epub 2008 Jun 3.
To determine the strength of association between the dose of inhaled corticosteroids (ICS) and risk of non-vertebral fracture in adults.
A systematic review and meta-analysis of case-control studies of non-vertebral fractures in adults, in which at least two doses of ICS were reported as the dose of beclomethasone dipropionate (BDP) or equivalent.
Five case-control studies were identified, with a total of 43 783 cases and 259 936 controls. There was an association between the risk of non-vertebral fracture and increasing dose of BDP. The random-effects odds ratio of relative risk for a non-vertebral fracture was 1.12 (95% confidence interval 1.00-1.26) per 1000 microg increase in the daily dose of BDP or equivalent.
In older adults, the relative risk of non-vertebral fractures increases by about 12% for each 1000 microg/day increase in the dose of BDP or equivalent. The magnitude of this risk was considerably less than other common risk factors for fracture in the older adult.
确定成人吸入性糖皮质激素（ICS）剂量与非椎体骨折风险之间的关联强度。
对成人非椎体骨折的病例对照研究进行系统评价和荟萃分析，其中至少报告了两种剂量的ICS，以丙酸倍氯米松（BDP）或等效剂量表示。
确定了五项病例对照研究，共有43783例病例和259936例对照。非椎体骨折风险与BDP剂量增加之间存在关联。每日BDP或等效剂量每增加1000微克，非椎体骨折相对风险的随机效应比值比为1.12（95%置信区间1.00 - 1.26）。
在老年人中，BDP或等效剂量每日每增加1000微克，非椎体骨折的相对风险增加约12%。该风险程度明显低于老年人骨折的其他常见风险因素。
