- Clinical Study
- Effects of Systemic Glucocorticoid Use on Fracture Risk: A Population-Based Study
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Ji Weon Koh, Junkang Kim, Hyemin Cho, Yong-Chan Ha, Tae-Young Kim, Young-Kyun Lee, Ha Young Kim, Sunmee Jang
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Endocrinol Metab. 2020;35(3):562-570. Published online September 22, 2020
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DOI: https://doi.org/10.3803/EnM.2020.659
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- Background
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.
Methods 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.
Results 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.
Conclusion 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.
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Citations
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
Masayuki Iki, Kenji Fujimori, Shinichi Nakatoh, Junko Tamaki, Shigeyuki Ishii, Nobukazu Okimoto, Hironori Imano, Sumito Ogawa Osteoporosis International.2024; 35(5): 805. 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
- Bone Metabolism
- Epidemiology of Osteoporosis and Osteoporotic Fractures in South Korea
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Young-Kyun Lee, Byung-Ho Yoon, Kyung-Hoi Koo
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Endocrinol Metab. 2013;28(2):90-93. Published online June 18, 2013
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DOI: https://doi.org/10.3803/EnM.2013.28.2.90
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4,900
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Several epidemiologic studies suggested that osteoporosis and osteoporotic fractures are not uncommon in South Korea. However, these previous cohort studies had limitations that may have influenced their results and the generalizability of the study conclusions, including small sample sizes, inclusion of only women, enrollment of participants from specific areas, and nonrandom selection of participants. Recently, epidemiologic studies using a nationwide claim register have been performed to overcome these limitations through collaboration between the Korean Society of Bone and Mineral Research and Health Insurance Review Assessments. Our review of the Korean Nationwide-database Osteoporosis Study could be helpful to obtain accurate incidence and prevalence estimations of osteoporosis and osteoporosis-related fractures in Korea.
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- The 2024 Guidelines for Osteoporosis - Korean Society of Menopause
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Hayoung Choi, Jungeun Shin, Jin-Hyung Jung, Kyungdo Han, Wonsuk Choi, Han Rim Lee, Jung Eun Yoo, Yohwan Yeo, Hyun Lee, Dong Wook Shin Frontiers in Public Health.2024;[Epub] CrossRef - Prevalence of osteoporosis and incidence of related fractures in developed economies in the Asia Pacific region: a systematic review
Manju Chandran, Katherine Brind’Amour, Saeko Fujiwara, Yong-Chan Ha, Hai Tang, Jawl-Shan Hwang, James Tinker, John A. Eisman Osteoporosis International.2023; 34(6): 1037. CrossRef - Effects of Bazedoxifene/Vitamin D Combination Therapy on Serum Vitamin D Levels and Bone Turnover Markers in Postmenopausal Women with Osteopenia: A Randomized Controlled Trial
Chaiho Jeong, Jeonghoon Ha, Jun-Il Yoo, Young-Kyun Lee, Jung Hee Kim, Yong-Chan Ha, Yong-Ki Min, Dong-Won Byun, Ki-Hyun Baek, Ho Yeon Chung Journal of Bone Metabolism.2023; 30(2): 189. CrossRef - Risk of Fractures in Thyroid Cancer Patients With Postoperative Hypoparathyroidism: A Nationwide Cohort Study in Korea
Seong Hee Ahn, You Jin Lee, Seongbin Hong, Jung Wee Park, Ye Jhin Jeon, Bit‐Na Yoo, Yong‐Chan Ha, Jean Kyung Bak, Ha Young Kim, Young‐Kyun Lee Journal of Bone and Mineral Research.2023; 38(9): 1268. CrossRef - Impact of changes in physical activity and incident fracture after acute ischemic stroke
Dae young Cheon, Kyung-Do Han, Jeen Hwa Lee, Kyung-Ho Yu, Bo Young Choi, Minwoo Lee Scientific Reports.2023;[Epub] CrossRef - Associations between Long-Term Air Pollution Exposure and Risk of Osteoporosis-Related Fracture in a Nationwide Cohort Study in South Korea
Seulkee Heo, Honghyok Kim, Sera Kim, Seung-Ah Choe, Garam Byun, Jong-Tae Lee, Michelle L. Bell International Journal of Environmental Research and Public Health.2022; 19(4): 2404. CrossRef - Significance of Measuring Lumbar Spine 3-Dimensional Computed Tomography Hounsfield Units to Predict Screw Loosening
Kyeong Hwan Kim, Tae-Hwan Kim, Seok Woo Kim, Ji Hee Kim, Heui Seung Lee, In Bok Chang, Joon Ho Song, Yong-Kil Hong, Jae Keun Oh World Neurosurgery.2022; 165: e555. CrossRef - Risk of osteoporotic fracture in older patients under antihypertensive treatment
Oh Kyung Kwon, Sun-Hwa Kim, Si-Hyuck Kang, Young-Kyun Lee, Chang-Hwan Yoon, Hae-Young Lee, Tae-Jin Youn, In-Ho Chae, Cheol-Ho Kim European Journal of Preventive Cardiology.2021; 28(11): e12. CrossRef - Risk factors for subsequent vertebral fractures following a previous hip fracture
Sang-Min Park, Sung Jun Go, Heesoo Han, Jung Wee Park, Young-Kyun Lee, Ho-Joong Kim, Jin S. Yeom, Kyung-Hoi Koo Journal of Bone and Mineral Metabolism.2021; 39(2): 193. CrossRef - Characteristics of Osteoporosis & Osteoporotic Fractures in Korea Based on Health Insurance Review and Assessment (HIRA) Database: 2009–2017
Ho-Seok Oh, Sung-Kyu Kim, Hyoung-Yeon Seo Healthcare.2021; 9(3): 324. CrossRef - Association between Irritable Bowel Syndrome and Risk of Osteoporosis in Korean Premenopausal Women
Sang-Yeoup Lee, Hye-Rim Hwang, Yu-Hyeon Yi, Jin-Mi Kim, Yun-Jin Kim, Jeong-Gyu Lee, Young-Hye Cho, Young-Jin Tak, Seung Hun Lee, Eun Ju Park, Youngin Lee Medical Principles and Practice.2021; 30(6): 527. CrossRef - Association Between Acetylcholinesterase Inhibitors and Osteoporotic Fractures in Older Persons With Alzheimer's Disease
Dae Yeon Won, Seong Jun Byun, Jin Sook Jeong, Ju-Young Shin Journal of the American Medical Directors Association.2020; 21(8): 1128. CrossRef - High Circulating Sphingosine 1-Phosphate is a Risk Factor for Osteoporotic Fracture Independent of Fracture Risk Assessment Tool
Seung Hun Lee, Jee Yang Lee, Kyeong-Hye Lim, Young-Sun Lee, Seong-Hee Kim, Sooyoung Choi, Seong-Hwan Cho, Jung-Min Koh Calcified Tissue International.2020; 107(4): 362. CrossRef - Osteoporosis and Osteoporotic Fracture Fact Sheet in Korea
Seong Hee Ahn, Sang-Min Park, So Young Park, Jun-Il Yoo, Hyoung-Seok Jung, Jae-Hwi Nho, Se Hwa Kim, Young-Kyun Lee, Yong-Chan Ha, Sunmee Jang, Tae-Young Kim, Ha Young Kim Journal of Bone Metabolism.2020; 27(4): 281. CrossRef - Assessing the effects of National Health Insurance reimbursement policy revisions for anti-osteoporotic drugs in Korean women aged 50 or older
Ja Seo Koo, Seong Hwan Moon, Hankil Lee, Sohee Park, Yun Mi Yu, Hye-Young Kang, Robert Daniel Blank PLOS ONE.2020; 15(12): e0244759. CrossRef - The Epidemiology of Fracture in Patients with Acute Ischemic Stroke in Korea
Kyung Bok Lee, Jung-Gon Lee, Beom Joon Kim, Jun Yup Kim, Keon-Joo Lee, Moon-Ku Han, Jong-Moo Park, Kyusik Kang, Yong-Jin Cho, Hong-Kyun Park, Keun-Sik Hong, Tai Hwan Park, Soo Joo Lee, Mi-Sun Oh, Kyung-Ho Yu, Byung-Chul Lee, Jae-Kwan Cha, Dae-Hyun Kim, Jo Journal of Korean Medical Science.2019;[Epub] CrossRef - Osteoporosis detection in panoramic radiographs using a deep convolutional neural network-based computer-assisted diagnosis system: a preliminary study
Jae-Seo Lee, Shyam Adhikari, Liu Liu, Ho-Gul Jeong, Hyongsuk Kim, Suk-Ja Yoon Dentomaxillofacial Radiology.2019; 48(1): 20170344. CrossRef - Medical Big Data Is Not Yet Available: Why We Need Realism Rather than Exaggeration
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Jesús Pérez-Rey, Raúl Roncero-Martín, Sergio Rico-Martín, Purificación Rey-Sánchez, Juan Pedrera-Zamorano, María Pedrera-Canal, Fidel López-Espuela, Jesús Lavado García Nutrients.2019; 11(3): 555. CrossRef - Effect of Training and Testing Condition of Convolutional Neural Network on evaluating Osteoporosis
Jae-Yun Kim, Jae-Seo Lee, Byung-Cheol Kang, Hyongsuk Kim, Shyam Adhikari, Liu Liu, Suk-Ja Yoon The Korean Journal of Oral and Maxillofacial Pathology.2019; 43(3): 73. CrossRef - Comparison of intraoperative radiation exposure with and without use of distal targeting device: a randomized control study
Jun-Il Yoo, Hojin Jeong, Jaeboem Na, Sang-Youn Song, Jung-Taek Kim, Yong-Han Cha, Chan Ho Park Archives of Orthopaedic and Trauma Surgery.2019; 139(11): 1579. CrossRef - Anemia and Risk of Fractures in Older Korean Adults: A Nationwide Population-Based Study
Eun Ae Lee, Dong Wook Shin, Jun Hyun Yoo, Hyeon Young Ko, Su Min Jeong Journal of Bone and Mineral Research.2019; 34(6): 1049. CrossRef - Elevated ceramides 18:0 and 24:1 with aging are associated with hip fracture risk through increased bone resorption
Beom-Jun Kim, Jin Young Lee, So Jeong Park, Seung Hum Lee, Su Jung Kim, Hyun Ju Yoo, Sarah I. Rivera De Pena, Meghan McGee-Lawrence, Carlos M. Isales, Jung-Min Koh, Mark W. Hamrick Aging.2019; 11(21): 9388. CrossRef - Effect of improved medication adherence on health care costs in osteoporosis patients
Hyemin Cho, Ji-Hye Byun, Inmyung Song, Ha Y. Kim, Yong-Chan Ha, Tae-Young Kim, Young-Kyun Lee, Sunmee Jang Medicine.2018; 97(30): e11470. CrossRef - Osteoporosis and fracture after gastrectomy for stomach cancer
Gi Hyeon Seo, Hae Yeon Kang, Eun Kyung Choe Medicine.2018; 97(17): e0532. CrossRef - Inflammation inhibitory effect of water extract from pumpkin’s tendril
Ha-Na Jeong, Ju-Hee Choi, Ha-Nul Lee, So-Hyeon Lee, Soon-Chang Cho, Jong-Hwan Park, Young-Min Kim Korean Journal of Food Preservation.2017; 24(8): 1122. CrossRef - Strong familial association of bone mineral density between parents and offspring: KNHANES 2008–2011
H. S. Choi, J. H. Park, S. H. Kim, S. Shin, M. J. Park Osteoporosis International.2017; 28(3): 955. CrossRef - Vertebral bone attenuation on low-dose chest CT: quantitative volumetric analysis for bone fragility assessment
Y. W. Kim, J. H. Kim, S. H. Yoon, J. H. Lee, C.-H. Lee, C. S. Shin, Y. S. Park Osteoporosis International.2017; 28(1): 329. CrossRef - Factors Affecting Bone Mineral Density Measurement after Fracture in South Korea
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Dong-Hwa Lee, Kyong Yeun Jung, A Ram Hong, Jung Hee Kim, Kyoung Min Kim, Chan Soo Shin, Seong Yeon Kim, Sang Wan Kim BMC Musculoskeletal Disorders.2016;[Epub] CrossRef - The Association of Higher Plasma Macrophage Migration Inhibitory Factor Levels with Lower Bone Mineral Density and Higher Bone Turnover Rate in Postmenopausal Women
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Sun-Young Jung, Hyun Soon Sohn, Eun-Ja Park, Hae Sun Suh, Ji-Won Park, Jin-Won Kwon, Chi-Ling Chen PLOS ONE.2016; 11(3): e0150531. CrossRef - The effects of body mass index on the hereditary influences that determine peak bone mass in mother–daughter pairs (KNHANES V)
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S. Y. Lee, S.-S. Kwon, H. S. Kim, J. H. Yoo, J. Kim, J. Y. Kim, B. C. Min, S. J. Moon, K. H. Sung Osteoporosis International.2015; 26(4): 1387. CrossRef - Osteoporosis in Healthy South Indian Males and the Influence of Life Style Factors and Vitamin D Status on Bone Mineral Density
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