Background: The objectives were to evaluate the frequency and risk factors for osteoporotic fractures in patients with different chronic inflammatory diseases.
Methods: The study was conducted in 34 centers of Russia. 2,342 patients (mean age 53,02±14,03 year, 591 male and 1181 female) completed a special questionnaire (including fractures, duration of the disease, dose and duration of glucocorticoid therapy, major risk factors for osteoporosis, etc.). The patients were divided into two groups according to long-term (3 month or more) oral glucocorticoid (OGC) use: Group 1 - never users (n=1403), Group 2 - current users and ex-users (n=939). Patients in both groups did not differ in age, body mass index (BMI), duration of the underlying disease, family history of hip fractures. The median duration of OGC therapy was 3 years, median daily prednisolone dose - 10 mg.
Results: 9.0% of Group 1 patients and 15.5% of Group 2 patients reported osteoporotic fractures. The patients age and the duration of chronic inflammatory disease were the significant fracture risks factors in never users group, but in Group 2 the only significant factor was the age. Osteoporotic fracture risk was increased in current and ex-users group compared with never users after adjustment for age, sex, BMI, duration of the underlying disease, family history of hip fractures, tobacco and alcoholic use. Odds ratio for all osteoporotic fractures was 2,2 (95% CI 1,63-3,02, p<0,001), for vertebral fractures - 5,04 (95% CI 2,05-12,37, p<0,001), for forearm fractures - 1,77 (1,10-2,84, p=0,02). The fracture incidence was increased in Group 2 patients of different sex and ages, but the significant risk elevation was demonstrated only in men ≧ 50 years and postmenopausal women.
Conclusion: The age, duration of the disease and chronic oral glucocorticoid use are the main fracture risk factors for patients with chronic inflammatory disease.
Disclosure: The authors declared no competing interests.