文档介绍：GIOP
GLUCOCORTICOID- INDUCED
OSTEOPOROSIS
概述
口糖皮质激素(GC)广泛用于风湿病、肾脏病、哮喘等的治疗
■英国报道,口服GC者约占该国***人口的1%
■在年龄70-79岁的老人中增加到240
■该国约有35万人存在GIOP的风险
口长期使用GC易出现许多并发症,其中GIOP最常见
GC治疗常见并发症
30
20
13
吸10
5
心心小
Ann rheum Dis. 2002 Jan; 61(1): 32-6.
骨质疏松症(OP)分类
口原发性骨质疏松症:如绝经后、老年性骨质疏松症等
口继发性骨质疏松症:如甲旁亢、GIOP(最常见)
口特发性骨质疏松症:如遗传性骨质疏松症等
GIOP
a 50% of glucocorticoid users lose bone(genetic variability)
30-50% of glucocorticoid users sustain vertebral fractures
d Rate of bone loss: up to 15 per annum
d Bone loss most pronounced in the first 6-12 months of
therapy
GIOP
Dose and Duration Dependent
Prednisone > mg will double the fracture risk
a Cumulative dose affects the severity of bone loss
a Alternate day dosing does work
a Inhaled steroids do result in bone loss
1000 ug /day per year BMD 0I Sd
Significant loss over 10-20 years
GIOP
a Trabecular bone is affected earlier and more severely than
cortical bone
Glucocorticoids often coexist with other risk factors
Rheumatoid arthritis and glucocorticoids increase vertebral
fracture risk by 4-5 fold compared to ra alone
Rheumatoid arthritis and glucocorticoids double hip
fracture risk compared to ra alone
a Men and women are equally susceptible to the effects of
glucocorticoids