title: Increased bone fracture prevalence in postmenopausal women suffering from pollen-allergy.
abstract: BACKGROUND
  Our aim was to investigate whether pollen-allergy can affect bone mass and fractures in postmenopausal women.
  
  
  METHODS
  A total of 125 postmenopausal pollen-allergic women (mean age: 61.26 yr) were split into four groups: (1) treated with neither H1 histamine receptor (H1R) antagonist nor inhaled corticosteroid (n=43); (2) treated only with H1R antagonist (n=53); (3) treated with both H1R antagonist and inhaled corticosteroid (n=17); (4) treated with only inhaled corticosteroid (n=12). Treatment, in the appropriate groups, had occurred for at least 5 years, seasonally. One-hundred non-allergic postmenopausal subjects matched for age, body mass index (BMI), and age at menopause served as controls.
  
  
  RESULTS
  Overweight and obesity (25 kg/m(2) < or =BMI) were common among the allergic women (76%). Allergic patients without treatment had a slightly lower bone density than their non-allergic counterparts. The rate (34.9%) of prevalent low-energy fractures (distal forearm, hip, and clinical vertebral fractures) in untreated allergic patients was almost triple that observed in non-allergic women (13%, chi(2) p=0.003). Bone fracture occurred more often in H1R-only treated patients (30.19%) than in controls (chi(2) p=0.01); however, clinical vertebral or hip fractures developed neither in those treated only with H1R antagonist nor in those who received both H1R antagonist and inhaled corticosteroid. Bone fractures were more frequent among patients with inhaled steroid treatment than among patients with a combined treatment of inhaled steroid and antihistamine (50 versus 29.4%). BMI predicted prevalent fractures at 1.278 (95% CI: 1.047-1.559, p=0.016) for a 1 kg/m(2) increase among untreated allergic patients.
  
  
  CONCLUSIONS
  In conclusion, we found a high prevalence of low-energy fractures among pollen-allergic postmenopausal women which was associated with obesity. It is possible that the H1R antagonists compensate for both the negative effect of pollen-allergy and the adverse effect of inhaled corticosteroid treatment on bone fracture risk.
authors.affiliation: 1st Department of Internal Medicine, Semmelweis University, Koranyi Sandor 2/A, 1083 Budapest, Hungary.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Ferencz
authors.forename: Szilvia
authors.initials: S
authors.lastname: Meszaros
authors.forename: Emoke
authors.initials: E
authors.lastname: Csupor
authors.forename: Edit
authors.initials: E
authors.lastname: Toth
authors.forename: Katalin
authors.initials: K
authors.lastname: Bors
authors.forename: Andras
authors.initials: A
authors.lastname: Falus
authors.forename: Csaba
authors.initials: C
authors.lastname: Horvath
mesh_terms: D000280:Administration, Inhalation; D015519:Bone Density / Q000276:immunology; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D005260:Female; D050723:Fractures, Bone / Q000150:complications*; D005938:Glucocorticoids / Q000008:administration & dosage; D006634:Histamine H1 Antagonists / Q000627:therapeutic use; D006636:Histamine Release; D006801:Humans; D006967:Hypersensitivity / Q000150:complications* / Q000188:drug therapy*; D008407:Mast Cells / Q000276:immunology; D008875:Middle Aged; D011058:Pollen; D017698:Postmenopause / Q000276:immunology
chemical_list: D005938:Glucocorticoids; D006634:Histamine H1 Antagonists