AbstractThe aim of the study was to establish the influence of glucocorticoids (GC) on
fracture risk, probability, and prevalence. A set of 1548 postmenopausal women
were divided into study group – treated with GC (n=114, age
66.48±7.6 years) and controls (n=1434, age 66.46±6.83
years). Data on clinical risk factors for osteoporosis and fractures were
collected. Hip bone densitometry was performed using a device Prodigy (GE, USA).
Fracture probability was established by FRAX, and fracture risk by Garvan
algorithm and POL-RISK. Fracture risk and fracture probability were
significantly greater for GC-treated women in comparison to controls. In the
study group, there were 24, 3, 24, and 6 fractures noted at spine, hip, forearm,
and arm, respectively. The respective numbers of fractures reported in controls
at those skeletal sites were: 186, 23, 240, and 25. The use of GCs increased
significantly prevalence of all major, spine and arm fractures. Also the number
of all fractures was affected by GC use. Following factors significantly
increased fracture probability: age (OR 1.04 per each year; 95% CI:
1.03–1.06), GC use (OR 1.54; 95% CI: 1.03–2.31), falls
(OR 2.09; 95% CI: 1.60–2.73), and FN T-score (OR 0.62 per each
unit; 95% CI: 0.54–0.71). In conclusion, in patients treated
with GCs the fracture risk, probability, and prevalence were increased. This
effect was evident regardless of whether GC therapy is included in the algorithm
as a risk factor (FRAX, POL-RISK) or not taken into consideration (Garvan
nomogram).