The effect of glucocorticoid on bone mineral density and bone turnover makers in patients with glomerular diseases / 实用医学杂志

ABSTRACT

Objective To investigate the the effect of long-term glucocorticoid on bone mineral density (BMD) and bone turnover makers in patients with glomerular diseases. Methods The dual-energy x-ray absorptiometry (DXA) was used to measure the bone mineral density of lumbar spine (L1~L4), femoral neck and trochanter of the 97 patients treated with glucocorticoid and the 20 patients in the control group. In addition , ELISA assay was used to measure the concentrations of bone turnover makers including serum PINP and CTX-I. Results (1)Compared with the control group, the BMD of lumbar spine (L1 ~ L4), femoral neck and trochanter and the concentrations of PINP were significantly lower, while the concentration of CTX-I was increased (P < 0.05);(2) Following up the passage of time and the accumulation of the amount of GC application , the BMD of lumbar spine , femoral neck and trochanter , and the concentrations of PINP decreased , while the concentration of CTX-I steadily increased (P<0.05);(3)Multiple linear regression analysis indicated that the BMD of lumbar spine and trochanter were negatively correlated with the time of GC application (P<0.01),and the concentrations of PINP and CTX-I were correlated with the cumulative doses of GC (r = -0.310 vs 0.221, P < 0.05);(4)The incidence of bone abnormalities in patients received vitamin D and calcium was markedly reduced (P<0.05). Conclusion The long-term glucocorticoid treatment for the patients with glomerular diseases can lead to bone mass reduction or osteoporosis , it can be helpful for early prevention and treatment of glucocorticoid osteoporosis with bone mineral density and bone turnover makers.