在年轻成年人中,葡萄糖皮质醇诱导的骨质疏松症的危险因素
Helena Florez1, Josep Lluis Carrasco2, Martina Barberá2
1Metabolic Bone Diseases Unit. Department of Rheumatology. Hospital Clinic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
Frontiers in endocrinology
|July 28, 2025
概括
葡萄糖皮质激素诱导的骨质疏松症 (GIOP) 影响超过40%的年轻成年人进行慢性葡萄糖皮质激素 (GC) 治疗. 较高的BMI,疾病活性和阴性腺体缺陷症是这一群体脆弱性骨折的关键风险因素.
科学领域:
- 内分泌学 在内分泌学.
- 骨的新陈代谢 骨的新陈代谢
- 老年病的医生 老年病的医生
背景情况:
- 葡萄糖皮质醇诱导的骨质疏松症 (GIOP) 是二次骨质疏松症的常见原因,特别是在年轻人中.
- 目前的指导方针仅限于50岁以下成年人的GIOP风险因素和治疗.
- 这项研究调查了GIOP和脆弱性骨折 (FF) 风险因素的年龄相关差异.
研究的目的:
- 为了确定葡萄糖皮质激素诱导的骨质疏松症 (GIOP) 和脆弱性骨折 (FF) 的风险因素在慢性葡萄糖皮质激素 (GC) 治疗的年轻人 (<50岁) 和老年人 (≥50岁) 之间是否有所不同.
- 在接受长期GC治疗的年轻成年人中确定GIOP和FF的特定风险因素.
主要方法:
- 对127名接受慢性GC治疗的患者的分析,评估GC剂量/持续时间,疾病活性,FF,人体测量,骨代谢 (包括性类固醇),骨矿物质密度,骨骨分数和脊椎骨折.
- GIOP被定义为密度计骨质疏松症和/或FF.
- 年轻 (<50岁) 和老年 (≥50岁) 患者群体之间的GIOP和FF风险因素的比较.
主要成果:
- 在各个年龄组中,GIOP的患病率相似 (44.4%在50岁以下的人 vs. 46.1%在50岁以上的人).
- 在年轻人中,脆弱性骨折 (FF) 的发生率较低 (13.9%对33%,p=0.046).
- 在年轻人中,较高的BMI和疾病活性被确定为FF的差异性风险因素;双胞胎缺血是一个独立于年龄的风险因素.
结论:
- 超过40%的慢性GC治疗的年轻人经历了GIOP.
- 增加的BMI,疾病活动,特别是阴性腺体缺陷症与年轻患者的FF发展有关.
- 识别这些风险因素对于早期发现和管理年轻GC用户骨折风险至关重要.
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