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Junkang Kim 1 Article
Clinical Study
Effects of Systemic Glucocorticoid Use on Fracture Risk: A Population-Based Study
Ji Weon Koh, Junkang Kim, Hyemin Cho, Yong-Chan Ha, Tae-Young Kim, Young-Kyun Lee, Ha Young Kim, Sunmee Jang
Endocrinol Metab. 2020;35(3):562-570.   Published online September 22, 2020
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  • 8 Web of Science
  • 8 Crossref
AbstractAbstract PDFPubReader   ePub   
Long-term glucocorticoid use increases fracture risk by reducing bone mass. This study evaluated the relationship between hip and vertebral fractures and the total amount of systematic glucocorticoid use.
We randomly selected 1,896,159 people aged 20 to 100 years who participated in the National Health Checkup program in 2006. The amount of glucocorticoids prescribed was calculated based on the defined daily dose (DDD). The total DDD was obtained by adding oral and parenteral glucocorticoids for 6 months from the index date. Subjects were categorized into four groups according to total glucocorticoid DDDs: non-users (DDDs=0), low users (0< DDDs ≤45), intermediate users (45< DDDs ≤90), and high users (90< DDDs). We followed them for 2 years. A multivariate Cox proportional hazard model was used to evaluate the effects of the total amount of glucocorticoid use on hip and vertebral fractures.
Higher glucocorticoid use was associated with a higher risk of vertebral fracture. Relative to non-users, the vertebral fracture risk was 1.39 times higher in the low-user group, 1.94 times higher in the intermediate-user group, and 2.43 times higher in the highuser group. The risk of hip fracture was 1.72 times higher in intermediate users and 3.28 times higher in high users than in non-users.
As the amount of glucocorticoid use for 6 months increased, the risk of hip and vertebral fractures became higher. In order to prevent fractures, it is necessary for doctors to evaluate the total amount of glucocorticoid prescribed to the patient and to provide appropriate treatment.


Citations to this article as recorded by  
  • Average daily glucocorticoid dose, number of prescription days, and cumulative dose in the initial 90 days of glucocorticoid therapy are associated with subsequent hip and clinical vertebral fracture risk: a retrospective cohort study using a nationwide h
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    Osteoporosis International.2024; 35(5): 805.     CrossRef
  • Low-dose glucocorticoid increase the risk of fracture in postmenopausal women with low bone mass: a retrospective cohort study
    So Young Park, Seong Hee Ahn, Gi Hwan Bae, Sunmee Jang, Mi Kyung Kwak, Ha Young Kim, Se Hwa Kim
    Osteoporosis International.2024;[Epub]     CrossRef
  • Chronic airway disease as a major risk factor for fractures in osteopenic women: Nationwide cohort study
    Sung Hye Kong, Ae Jeong Jo, Chan Mi Park, Kyun Ik Park, Ji Eun Yun, Jung Hee Kim
    Frontiers in Endocrinology.2023;[Epub]     CrossRef
  • Bad to the bones: prescribing of drugs for the prevention and treatment of osteoporosis in patients on chronic glucocorticoids
    Sarah J. Billups, Vinh K Thai, Jacob Denkins, Ian C. Dettman, Micol S. Rothman
    Archives of Osteoporosis.2023;[Epub]     CrossRef
  • High Risk of Fractures Within 7 Years of Diagnosis in Asian Patients With Inflammatory Bowel Diseases
    Hyung Jin Ahn, Ye-Jee Kim, Ho-Su Lee, Jin Hwa Park, Sung Wook Hwang, Dong-Hoon Yang, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Beom-Jun Kim, Sang Hyoung Park
    Clinical Gastroenterology and Hepatology.2022; 20(5): e1022.     CrossRef
  • Challenges in the diagnosis and management of glucocorticoid‐induced osteoporosis in younger and older adults
    Madhuni Herath, Bente Langdahl, Peter R. Ebeling, Frances Milat
    Clinical Endocrinology.2022; 96(4): 460.     CrossRef
  • Comparative effectiveness of bisphosphonate treatments for the prevention of re-fracture in glucocorticoid-induced osteoporosis: protocol for a systematic review and meta-analysis
    Hongmin Chu, Bo-Hyoung Jang, GaYoon Kim, Seowoo Bae, Hyeju Lee, Seonghee Nam, Jeonghoon Ahn
    BMJ Open.2022; 12(9): e062537.     CrossRef
  • Why Do We Need Proactive Management for Fracture Prevention in Long-Term Glucocorticoid Users?
    Han Seok Choi
    Endocrinology and Metabolism.2020; 35(3): 549.     CrossRef
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