Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan

Soen, Satoshi; Kaku, Miki; Okubo, Naoki; Touzeni, Salsabil; Saito, K.; Kobayashi, Makiko

doi:10.1007/s00774-021-01236-z

Cited by 10 publications

(7 citation statements)

References 64 publications

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“…The study included a population with a mean age of 68.5 years, with 90.5% of patients being over the age of 50. 44 …”

Section: Disparities In Osteoporosis Epidemiology According To Sexmentioning

confidence: 99%

Insights and implications of sexual dimorphism in osteoporosis

Zhang,

Xie,

Sun

et al. 2024

Bone Res

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Osteoporosis, a metabolic bone disease characterized by low bone mineral density and deterioration of bone microarchitecture, has led to a high risk of fatal osteoporotic fractures worldwide. Accumulating evidence has revealed that sexual dimorphism is a notable feature of osteoporosis, with sex-specific differences in epidemiology and pathogenesis. Specifically, females are more susceptible than males to osteoporosis, while males are more prone to disability or death from the disease. To date, sex chromosome abnormalities and steroid hormones have been proven to contribute greatly to sexual dimorphism in osteoporosis by regulating the functions of bone cells. Understanding the sex-specific differences in osteoporosis and its related complications is essential for improving treatment strategies tailored to women and men. This literature review focuses on the mechanisms underlying sexual dimorphism in osteoporosis, mainly in a population of aging patients, chronic glucocorticoid administration, and diabetes. Moreover, we highlight the implications of sexual dimorphism for developing therapeutics and preventive strategies and screening approaches tailored to women and men. Additionally, the challenges in translating bench research to bedside treatments and future directions to overcome these obstacles will be discussed.

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“…The study included a population with a mean age of 68.5 years, with 90.5% of patients being over the age of 50. 44 …”

Section: Disparities In Osteoporosis Epidemiology According To Sexmentioning

confidence: 99%

Insights and implications of sexual dimorphism in osteoporosis

Zhang,

Xie,

Sun

et al. 2024

Bone Res

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“…A study in Japan pointed out that the probability of fracture was 23.7% and the risk of death was higher in patients treated with high dose of glucocorticoid ( 18 ). Glucocorticoid not only directly inhibits osteogenesis by promoting osteoblast and osteocyte apoptosis, reducing osteogenic function, inhibiting collagen, promoting osteoclast generation and prolonging its survival time, but also indirectly affects bone formation by regulating endocrine and related cytokines and inhibiting bone local blood flow ( 19 ). Therefore, unless it is necessary for treatment, we suggest that patients with osteoporosis should not use glucocorticoid as much as possible.…”

Section: Discussionmentioning

confidence: 99%

Construction and verification of risk prediction model of osteoporotic fractures in patients with osteoporosis in China

Xia,

Jiang,

Cai

et al. 2024

Front. Public Health

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ObjectiveTo explore the influencing factors of osteoporotic fractures (OPF) in patients with osteoporosis, construct a prediction model, and verify the model internally and externally, so as to provide reference for early screening and intervention of OPF in patients with osteoporosis.MethodsOsteoporosis patients in the First Affiliated Hospital of Soochow University were selected, and the medical records of patients were consulted through the Hospital Information System (HIS) and the data management platform of osteoporosis patients, so as to screen patients who met the criteria for admission and discharge and collect data. SPSS 26.0 software was used for single factor analysis to screen statistically significant variables (p < 0.05). The influencing factors of OPF were determined by multivariate analysis, and a binary Logistic regression model was established according to the results of multivariate analysis. Hosmer-Lemeshow (H-L) goodness of fit and receiver operating characteristic curve (ROC) were used to test the model’s efficiency, and Stata 16.0 software was used to verify the Bootstrap model, draw the model calibration curve, clinical applicability curve and nomogram.ResultsIn this study, the data of modeling set and verification set were 1,435 and 580, respectively. There were 493 (34.4%) cases with OPF and 942 (65.6%) cases without OPF in the modeling set. There were 204 (35.2%) cases with OPF and 376 (64.8%) cases without OPF. The variables with statistically significant differences in univariate analysis are Age, BMI, History of falls, Usage of glucocorticoid, ALP, Serum Calcium, BMD of lumbar, BMD of feminist neck, T value of feminist neck, BMD of total hip and T value of total hip. The area under ROC curve of the risk prediction model constructed this time is 0.817 [95%CI (0.794 ~ 0.839)], which shows that the model has a good discrimination in predicting the occurrence of OPF. The optimal threshold of the model is 0.373, the specificity is 0.741, the sensitivity is 0.746, and the AUC values of the modeling set and the verification set are 0.8165 and 0.8646, respectively. The results of Hosmer and Lemeshow test are modeling set: (χ2 = 6.551, p = 0.586); validation set: [(χ2 = 8.075, p = 0.426)]. The calibration curve of the model shows that the reference line of the fitted curve and the calibration curve is highly coincident, and the model has a good calibration degree for predicting the occurrence of fractures. The net benefit value of the risk model of osteoporosis patients complicated with OPF is high, which shows that the model is effective.ConclusionIn this study, a OPF risk prediction model is established and its prediction efficiency is verified, which can help identify the high fracture risk subgroup of osteoporosis patients in order to choose stronger intervention measures and management.

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“…However, these monitoring rates may be underestimated if densitometry was performed at a different care facility to that at which ADT was prescribed. We have previously reported a significant treatment gap in bone density monitoring in another group of patients at risk for osteoporotic fractures, namely those treated with glucocorticoids, of whom only 6.5% were monitored [ 30 ]. However, in the case of men starting ADT, the gap is even bigger.…”

Section: Discussionmentioning

confidence: 99%

Androgen deprivation therapy-related fracture risk in prostate cancer: an insurance claims database study in Japan

Matsushima,

Taguchi,

Kodama

et al. 2024

J Bone Miner Metab

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Introduction Androgen deprivation therapy (ADT) is widely used for the treatment of prostate cancer. ADT is associated with reduced bone density leading to an increased risk of osteoporotic fracture. The objective of this retrospective cohort study was to quantify fracture risk in men treated with ADT for prostate cancer in real-world practice in Japan. Materials and methods Data were extracted from the Japanese Medical Data Vision (MDV) database. Men initiating ADT for treatment of prostate cancer between April 2010 and March 2021 were identified and matched to a cohort of prostate cancer patients not taking ADT using a propensity score. Fracture rates were estimated by a cumulative incidence function and compared between cohorts using a Cox cause-specific hazard model. Information was extracted on demographics, comorbidities and bone densitometry. Results 30,561 men with PC starting ADT were matched to 30,561 men with prostate cancer not treated with ADT. Following ADT initiation, <5% of men underwent bone densitometry. Prescription of ADT was associated with an increased fracture risk compared to not taking ADT (adjusted hazard ratio: 1.63 [95% CI 1.52–1.75]). Conclusion ADT is associated with a 1.6-fold increase in the risk of osteoporotic fracture in men with prostate cancer. Densitometry in this population is infrequent and monitoring urgently needs to be improved in order to implement effective fracture prevention.

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Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan

Cited by 10 publications

References 64 publications

Insights and implications of sexual dimorphism in osteoporosis

Insights and implications of sexual dimorphism in osteoporosis

Construction and verification of risk prediction model of osteoporotic fractures in patients with osteoporosis in China

Androgen deprivation therapy-related fracture risk in prostate cancer: an insurance claims database study in Japan

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