Konno Shingo, Suzuki Shigeaki, Masuda Masayuki, Nagane Yuriko, Tsuda Emiko, Murai Hiroyuki, Imai Tomihiro, Fujioka Toshiki, Suzuki Norihiro, Utsugisawa Kimiaki
Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan.
Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
PLoS One. 2015 May 12;10(5):e0126579. doi: 10.1371/journal.pone.0126579. eCollection 2015.
To investigate the association between glucocorticoid-induced osteoporosis and myasthenia gravis (MG) using a cross-sectional survey in Japan.
We studied 363 patients with MG (female 68%; mean age, 57 ± 16 years) who were followed at six Japanese centers between April and July 2012. We evaluated the clinical information of MG and fractures, bone markers, and radiological assessment. Quality of life was measured using an MG-specific battery, MG-QOL15.
Glucocorticoids were administered in 283 (78%) of 363 MG patients. Eighteen (6%) of 283 MG patients treated with prednisolone had a history of osteoporotic fractures. The duration of glucocorticoid therapy, but not the dose of prednisolone, was associated with the osteoporotic fractures in MG patients. Bone mineral density was significantly decreased in the MG patients with fractures. The multivariate analyses showed that the total quantitative MG score was the only independent factor associated with osteoporotic fractures (OR = 1.30, 95% CI 1.02-1.67, p = 0.03). MG patients who had experienced fractures reported more severe difficulties in activities of daily living.
Glucocorticoid-induced osteoporosis aggravates quality of life in patients with MG.
在日本进行一项横断面调查，以研究糖皮质激素诱导的骨质疏松症与重症肌无力（MG）之间的关联。
我们研究了2012年4月至7月期间在日本六个中心随访的363例MG患者（女性占68%；平均年龄57±16岁）。我们评估了MG的临床信息、骨折情况、骨标志物和影像学评估。使用MG特异性量表MG-QOL15测量生活质量。
363例MG患者中有283例（78%）接受了糖皮质激素治疗。在接受泼尼松龙治疗的283例MG患者中，有18例（6%）有骨质疏松性骨折病史。糖皮质激素治疗的持续时间而非泼尼松龙的剂量与MG患者的骨质疏松性骨折有关。骨折的MG患者骨密度显著降低。多因素分析显示，MG总定量评分是与骨质疏松性骨折相关的唯一独立因素（OR = 1.30，95%CI 1.02 - 1.67，p = 0.03）。经历过骨折的MG患者在日常生活活动中报告有更严重的困难。
糖皮质激素诱导的骨质疏松症会加重MG患者的生活质量。
