Inhaled steroids do not decrease bone mineral density but increase risk of fractures: data from the GIUMO Study Group.
Although the negative effect of systemic steroids on bone is well documented, there is not clear evidence about possible adverse effects of inhaled steroids on bone metabolism and fractures. A cross-sectional study was performed on 105 women suffering from bronchial asthma treated with inhaled steroids and 133 controls. Bone mineral density (BMD) was measured by quantitative ultrasonography (QUS) at the calcaneus and by dual X-ray absorptiometry (DXA), at both the lumbar spine and proximal femur. Patients suffering from bronchial asthma showed no statistically significant changes in BMD as measured by DXA or QUS, compared with controls. A higher prevalence of fractures was found in the group of women with bronchial asthma, with an age-adjusted odds ratio of 2.79 (95% CI: 1.19-6.54). Inhaled steroids do not appear to decrease BMD, but are associated with an increased risk of fracture in women.
Sosa
M
M
University of Las Palmas de Gran Canria, Hospital University Insular, Bone Metabolic Unit, Apartado 550, 35080 Las Palmas de Gran Canaria, Canary Islands, Spain. manuelsosah@canariastelecom.com
Saavedra
P
P
Valero
C
C
Guañabens
N
N
Nogués
X
X
del Pino-Montes
J
J
Mosquera
J
J
Alegre
J
J
Gómez-Alonso
C
C
Muñoz-Torres
M
M
Quesada
M
M
Pérez-Cano
R
R
Jódar
E
E
Torrijos
A
A
Lozano-Tonkin
C
C
Díaz-Curiel
M
M
D015502:Absorptiometry, Photon; D000280:Administration, Inhalation; D000328:Adult; D001249:Asthma / Q000188:drug therapy; D015519:Bone Density / Q000187:drug effects*; D002111:Calcaneus / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000502:physiology; D050723:Fractures, Bone / Q000139:chemically induced / Q000175:diagnosis; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000502:physiology; D008875:Middle Aged; D014463:Ultrasonography
D005938:Glucocorticoids