title: Association between Glucocorticoid-Induced Osteoporosis and Myasthenia Gravis: A Cross-Sectional Study.
abstract: OBJECTIVE
  To investigate the association between glucocorticoid-induced osteoporosis and myasthenia gravis (MG) using a cross-sectional survey in Japan.
  
  
  METHODS
  We studied 363 patients with MG (female 68%; mean age, 57 ± 16 years) who were followed at six Japanese centers between April and July 2012. We evaluated the clinical information of MG and fractures, bone markers, and radiological assessment. Quality of life was measured using an MG-specific battery, MG-QOL15.
  
  
  RESULTS
  Glucocorticoids were administered in 283 (78%) of 363 MG patients. Eighteen (6%) of 283 MG patients treated with prednisolone had a history of osteoporotic fractures. The duration of glucocorticoid therapy, but not the dose of prednisolone, was associated with the osteoporotic fractures in MG patients. Bone mineral density was significantly decreased in the MG patients with fractures. The multivariate analyses showed that the total quantitative MG score was the only independent factor associated with osteoporotic fractures (OR = 1.30, 95% CI 1.02-1.67, p = 0.03). MG patients who had experienced fractures reported more severe difficulties in activities of daily living.
  
  
  CONCLUSIONS
  Glucocorticoid-induced osteoporosis aggravates quality of life in patients with MG.
authors.affiliation: Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Konno
authors.affiliation: Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Masuda
authors.affiliation: Department of Neurology, Hanamaki General Hospital, Iwate, Japan.
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Nagane
authors.affiliation: Department of Neurology, Sapporo Medical University, Hokkaido, Japan.
authors.forename: Emiko
authors.initials: E
authors.lastname: Tsuda
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
authors.affiliation: Department of Neurology, Sapporo Medical University, Hokkaido, Japan.
authors.forename: Tomihiro
authors.initials: T
authors.lastname: Imai
authors.affiliation: Department of Neurology, Toho University Ohashi Medical Center, Tokyo, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Fujioka
authors.affiliation: Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Suzuki
authors.affiliation: Department of Neurology, Hanamaki General Hospital, Iwate, Japan.
authors.forename: Kimiaki
authors.initials: K
authors.lastname: Utsugisawa
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology*; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology*; D010024:Osteoporosis / Q000139:chemically induced / Q000453:epidemiology / Q000503:physiopathology*; D011788:Quality of Life
chemical_list: D005938:Glucocorticoids