Biological Heterogeneity in Susceptibility to Glucocorticoid-Induced Bone Loss: Short- and Long-Term Hip BMD Trajectories
Authors' conclusion
The findings confirm the association between initial GC exposure and significant bone loss. The heterogeneity in individual responses emphasizes the need for early monitoring and personalized approaches in managing bone health for patients undergoing GC treatment.
Study context
- Population
- GC treatment-naive adults without bone protective agents with routine DXA at Odense University Hospital, Funen, Denmark, 2006–2021
- Participants
- 15,099 adults
- Exposure
- Systemic GC exposure vs no GC exposure
- Outcome
- Short-term: annualized THBMD change between first 2 DXA scans; long-term: >5% annualized THBMD loss
- Follow-up
- 10-year (long-term)
Methodological detailsroutine-care DXA data, register-enriched, stratified by sex and tertiles of GC exposure
- Routine-care DXA data
- Register-enriched
- Stratified by sex and tertiles of GC exposure
Main finding
As reported in the abstract
THBMD loss (short- and long-term)
- Strong associations between GC exposure and total hip bone mineral density (THBMD) loss for both outcomes, with larger losses in the middle and upper tertiles of GC exposure
- Risk of >5% annualized THBMD loss elevated, especially in the first 2 years of initiating GC treatment
Observational data: associations, not effects.
Further findings
Heterogeneity in THBMD responses
- Significant heterogeneity; ≈1 in 5 patients had no nominal bone loss despite upper tertile GC exposure
Original publication
Biological Heterogeneity in Susceptibility to Glucocorticoid-Induced Bone Loss: Short- and Long-Term Hip BMD Trajectories. J Clin Endocrinol Metab. Published 3 December 2024. doi:10.
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