Florez Helena, Carrasco Josep Lluis, Barberá Martina, Hernández-Rodríguez José, Muxi Africa, Mocritcaia Anastasia, Prieto-González Sergio, Cid Maria C, Monegal Ana, Guañabens Núria, Peris Pilar
Metabolic Bone Diseases Unit. Department of Rheumatology. Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Biostatistics, Department of Basic Clinical Practice, University of Barcelona, Barcelona, Spain.
Front Endocrinol (Lausanne). 2025 Jul 11;16:1528962. doi: 10.3389/fendo.2025.1528962. eCollection 2025.
Glucocorticoid-induced osteoporosis (GIOP) is one of the most frequent causes of secondary osteoporosis, especially in young subjects. However, current research and guidelines have scarcely addressed the therapeutic approach and risk factors for GIOP in adults less than 50 years of age. The aim of the study was to analyze if factors related to the development of glucocorticoid-induced osteoporosis (GIOP) and fragility fractures (FF) differ according to age.
127 patients on chronic glucocorticoid (GC) treatment were analyzed, including GC doses and duration, disease activity, FF, anthropometric data, bone metabolism parameters (including sex steroids), bone mineral density, trabecular bone score, and radiologic vertebral fractures; defining GIOP as densitometric osteoporosis and/or FF. Young subjects (<50 years old) were compared with those ≥50 years for risk factors of GIOP and FF.
GIOP prevalence was similar in both age groups: <50 (n=36) 44.4% 46.1% ≥50 years (n=91). Five subjects <50 (13.9%) and 30 ≥50 years (33%) presented FF (p=0.046). Having a higher body mass index (BMI), disease activity was a differential risk factor for FF in young subjects, whereas hypogonadism was a risk factor independent of age.
More than 40% of young subjects on chronic GC therapy had GIOP. A higher BMI and disease activity and particularly, hypogonadism seem to be factors related to FF development in these subjects. Evaluation of these risk factors can improve the identification of young subjects at increased risk of fracture.
糖皮质激素性骨质疏松症（GIOP）是继发性骨质疏松症最常见的病因之一，尤其是在年轻患者中。然而，目前的研究和指南几乎未涉及50岁以下成年人GIOP的治疗方法和危险因素。本研究的目的是分析与糖皮质激素性骨质疏松症（GIOP）和脆性骨折（FF）发生相关的因素是否因年龄而异。
对127例接受慢性糖皮质激素（GC）治疗的患者进行分析，包括GC剂量和疗程、疾病活动度、FF、人体测量数据、骨代谢参数（包括性激素）、骨密度、小梁骨评分和放射学椎体骨折；将GIOP定义为密度测定法诊断的骨质疏松症和/或FF。比较年轻患者（<50岁）和≥50岁患者GIOP和FF的危险因素。
两个年龄组的GIOP患病率相似：<50岁（n=36）为44.4%，≥50岁（n=91）为46.1%。<50岁的5例患者（13.9%）和≥50岁的30例患者（33%）发生了FF（p=0.046）。较高的体重指数（BMI）、疾病活动度是年轻患者FF的差异危险因素，而性腺功能减退是与年龄无关的危险因素。
超过40%接受慢性GC治疗的年轻患者患有GIOP。较高的BMI、疾病活动度，尤其是性腺功能减退似乎是这些患者FF发生的相关因素。对这些危险因素的评估可改善对骨折风险增加的年轻患者的识别。
