Salem Dorria, Talaat Soha, Abdel-Halim Mona R E, Mohsen Kareem Mohammed
dept.of dermatology & radiodiagnosis, Cairo University, Cairo, Egypt.
Indian J Dermatol. 2010 Jul-Sep;55(3):238-45. doi: 10.4103/0019-5154.70669.
Corticosteroids are mainstay of dermatological therapy and they are also a well known cause of osteoporosis. The objective of the present study was to find out the influence of the systemic intake of corticosteroids, either by the oral route or by IV pulse administration, on bone mineral density in dermatological patients using dual X-ray absorptiometry (DXA).
This study was carried on 100 patients and 55 controls. The first group of patients included 55 patients undergoing long-term oral corticosteroid therapy daily and the second group included 45 patients who received IV dexamethasone pulse therapy. DXA was measured once for both the controls and patients in group 1. DXA was measured twice for patients in group 2, before starting pulse therapy (baseline DXA) and six months after regular treatment with pulse therapy (follow-up DXA).
The results show that significant reduction in BMD occurs in both groups, however, oral corticosteroids produce significantly more reduction in BMD in the lumbar spine. BMD was not found to be affected by the cumulative doses of corticosteroids, the duration of daily oral corticosteroid intake, or the number of IV dexamethasone pulses.
Corticosteroid treatment causes significant BMD loss in patients treated by either route. Prophylactic treatment against osteoporosis is mandatory in patients receiving either form of corticosteroids.
皮质类固醇是皮肤科治疗的主要药物,也是众所周知的骨质疏松症病因。本研究的目的是通过双能X线吸收法(DXA),了解口服或静脉脉冲给药的全身性皮质类固醇摄入对皮肤科患者骨密度的影响。
本研究纳入100例患者和55例对照。第一组患者包括55例每日接受长期口服皮质类固醇治疗的患者,第二组包括45例接受静脉地塞米松脉冲治疗的患者。对对照组和第一组患者均进行一次DXA测量。对第二组患者在开始脉冲治疗前(基线DXA)和脉冲治疗常规治疗6个月后(随访DXA)进行两次DXA测量。
结果显示两组患者的骨密度均显著降低,然而,口服皮质类固醇使腰椎骨密度降低更为显著。未发现骨密度受皮质类固醇累积剂量、每日口服皮质类固醇摄入持续时间或静脉地塞米松脉冲次数的影响。
无论采用何种给药途径,皮质类固醇治疗均会导致患者骨密度显著降低。接受任何一种皮质类固醇治疗的患者均必须进行骨质疏松症的预防性治疗。