Abstract:
PURPOSE:To evaluate the effects of different definitions of glucocorticoid (GC) exposure on the magnitude and pattern of fracture risk using the same dataset. METHODS:Data from patients with rheumatoid arthritis (RA) were extracted from the Clinical Practice Research Datalink, a primary care database with electronic health records in the United Kingdom. Patients exposed to oral GCs were matched to up to two unexposed patients by age, gender and location. The first osteoporotic fracture was identified and adjusted and unadjusted cox proportional hazard ratios (HR) and 95% confidence intervals (CI) produced for fracture risk following GC therapy using different models of risk attribution. These include models demonstrating the effect of dose, duration and recency of GC exposure. RESULTS:There were 16,507 patients included. Exposed patients were older and had more comorbidities. GC therapy was associated with an increased risk of fracture, with the effect size influenced by risk attribution model. The risk of fracture decreased with less recent exposure from HR (95% CI) 1.66 (1.27, 2.16) during the first month of stopping GCs to 1.11 (0.79, 1.57) for between 1 and 3 months. The risk of fracture increased with current daily dose, HR 1.44 (1.17, 1.77) for 5-9.9 mg prednisolone equivalent dose (PEQ) to 3.02 (1.77, 5.15) for 15-19.9 mg PEQ. Risk of fracture increased with cumulative dose, a function of dose and duration, from HR 1.22 (1.03, 1.44) for <1 g to 1.83 (1.35, 2.48) for 7.5-10 g. CONCLUSION:GC exposure was associated with excess fracture risk, with effect size differing according to definition of exposure. This highlights the need to incorporate all exposure dimensions (dose, duration and recency) in these patient's fracture risk assessments.
journal_name
Bonejournal_title
Boneauthors
Robinson DE,van Staa TP,Dennison EM,Cooper C,Dixon WGdoi
10.1016/j.bone.2018.09.004subject
Has Abstractpub_date
2018-12-01 00:00:00pages
83-90eissn
8756-3282issn
1873-2763pii
S8756-3282(18)30342-9journal_volume
117pub_type
杂志文章相关文献
BONE文献大全abstract::It is now well established that important regulatory interactions occur between the cells in the hematopoietic, immune and skeletal systems (osteoimmunology). B lymphocytes (B cells) are responsible for the generation and production of antibodies or immunoglobulins in the body. Together with T cells these lymphocytes ...
journal_title:Bone
pub_type: 杂志文章,评审
doi:10.1016/j.bone.2010.06.011
更新日期:2010-09-01 00:00:00
abstract::Fibroblast growth factor 23 (FGF23) circulates as active protein and inactive fragments. Low iron status increases FGF23 gene expression, and iron deficiency is common. We hypothesized that in healthy premenopausal women, serum iron influences C-terminal and intact FGF23 concentrations, and that iron and FGF23 associa...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2016.03.005
更新日期:2016-05-01 00:00:00
abstract::With age, alterations occurring in bone quality, quantity, and microarchitecture affect the resistance of trabecular bone to local failure. The clinical implications of these changes are evident by the observed exponential increase in fracture incidence with age. Although age-related development of skeletal fragility ...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2006.10.028
更新日期:2007-04-01 00:00:00
abstract::On the basis of studies with bone-seeking isotopes, it is generally believed that the metabolic activity of osteoblasts of the trabecular bone is greater than that of the osteoblasts of the cortex. This implies that the oxidative activity, which provides the energy for biosyntheses, will also be greater in the former ...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/8756-3282(89)90061-6
更新日期:1989-01-01 00:00:00
abstract::Diabetes is associated with a number of lower extremity orthopedic conditions and complications including fractures, Charcot neuroarthropathy, plantar ulcers, and infection. These complications are of significant clinical concern in terms of morbidity, mortality, and socioeconomic costs. A review of each condition is ...
journal_title:Bone
pub_type: 杂志文章,评审
doi:10.1016/j.bone.2015.07.029
更新日期:2016-01-01 00:00:00
abstract::Bone marrow mesenchymal stem cells (BMMSCs) provide the biological basis for bone reconstruction. Mechanical tension stimulation as a potent modulator is able to promote osteogenic capability of BMMSCs. Long non-coding RNAs (LncRNAs) as competing endogenous RNAs (ceRNAs) for microRNAs, are postulated to regulate the o...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2017.12.013
更新日期:2018-03-01 00:00:00
abstract::Epigenetic regulatory proteins support mammalian development, cancer, aging and tissue repair by controlling many cellular processes including stem cell self-renewal, lineage-commitment and senescence in both skeletal and non-skeletal tissues. We review here our knowledge of epigenetic regulatory protein complexes tha...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2020.115659
更新日期:2021-02-01 00:00:00
abstract:PURPOSE:Clinical and in vitro studies suggest that subchondral bone sclerosis due to abnormal osteoblasts is involved in the progression of osteoarthritis (OA). Human osteoblasts isolated from sclerotic subchondral OA bone tissue show an altered phenotype, a decreased canonical Wnt/ß-catenin pathway, and a reduced mine...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2015.02.001
更新日期:2015-06-01 00:00:00
abstract::Vertebral fracture risk is a heritable complex trait. The aim of this study was to identify genetic susceptibility factors for osteoporotic vertebral fractures applying a genome-wide association study (GWAS) approach. The GWAS discovery was based on the Rotterdam Study, a population-based study of elderly Dutch indivi...
journal_title:Bone
pub_type: 杂志文章
doi:
更新日期:2014-02-01 00:00:00
abstract:PURPOSE:Low trauma rib fracture (hereinafter, rib fracture) is common in the elderly, but its risk factors and mortality consequence are rarely studied. We sought to define the epidemiology of rib fracture and the association between rib fracture and postfracture mortality. METHODS:The study was part of the Dubbo Oste...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2018.08.016
更新日期:2018-11-01 00:00:00
abstract::Bone is a composite biomaterial of mineral crystals, organic matrix, and water. Each contributes to bone quality and strength and may change independently, or together, with disease progression and treatment. Even so, there is a near ubiquitous reliance on ionizing x-ray-based approaches to measure bone mineral densit...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2020.115615
更新日期:2021-02-01 00:00:00
abstract::Bone is a highly dynamic organ in which several cell types function cooperatively. Among these, osteocytes have recently emerged as an important regulator of bone homeostasis, although their mechanism of regulation is unclear. Here, intravital bone imaging by two-photon excitation microscopy allowed us to directly vis...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2015.01.013
更新日期:2015-05-01 00:00:00
abstract::Osteoporosis is a major public health problem in Western countries and is projected to have a similar impact in the Middle East. It has been suggested that peak bone mineral density (BMD), a major determinant of osteoporotic fractures later in life, may be lower in this part of the world compared with the Western worl...
journal_title:Bone
pub_type: 临床试验,杂志文章
doi:10.1016/s8756-3282(02)00845-1
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND AND AIM:Bone mineral density (BMD) is under strong genetic regulation, but it is not clear which genes are involved in the regulation, particularly in Asian populations. This study sought to determine the association between 29 genes discovered by Caucasian-based genome-wide association studies and BMD in a ...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2015.03.003
更新日期:2015-07-01 00:00:00
abstract::Approximately 5% of all military recruits incur stress fracture injuries during intense physical training, predominately in the lower extremity. We compared young men and women with stress fracture injury (subjects) to a matched group of uninjured volunteers (controls) during a summer training program at the United St...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2004.05.014
更新日期:2004-09-01 00:00:00
abstract::While increasing age, decreasing body mass index (BMI), and physical inactivity are known to increase hip fracture risk, whether these factors have similar effects on other common fractures is not well established. We used prospectively-collected data from a large cohort to examine the role of these factors on the ris...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2012.03.014
更新日期:2012-06-01 00:00:00
abstract::Peroxisome proliferator activated receptors (PPARs) are DNA-binding nuclear hormone receptors that are upregulated in response to high fat diets. PPARs are structurally related to the type II nuclear receptors, including the thyroid hormone receptors (TRs). To investigate if PPARs modulate TR-mediated terminal differe...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2005.04.031
更新日期:2005-09-01 00:00:00
abstract::Osteocytes form over 90% of the bone cells and are postulated to be mechanosensors responsible for regulating the function of osteoclasts and osteoblasts in bone modeling and remodeling. Physical activity results in mechanical loading on the bones. Osteocytes are thought to be the main mechanosensory cells in bone. Up...
journal_title:Bone
pub_type: 杂志文章,评审
doi:10.1016/j.bone.2020.115328
更新日期:2020-08-01 00:00:00
abstract::Deficiency of Sirtuin 6 (SIRT6), a chromatin-related deacetylase, in mice reveals severe premature aging phenotypes including osteopenia. However, the underlying molecular mechanisms of SIRT6 in bone metabolism are unknown. Here we show that SIRT6 deficiency in mice produces low-turnover osteopenia caused by impaired ...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2015.07.018
更新日期:2015-12-01 00:00:00
abstract::This paper describes a new alternative for individualized mechanical analysis of bone trabecular structure. This new method closes the gap between the classic homogenization approach that is applied to macro-scale models and the modern micro-finite element method that is applied directly to micro-scale high-resolution...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2010.12.022
更新日期:2011-04-01 00:00:00
abstract::Avian tibial dyschondroplasia is a disorder of endochondral ossification which results in the accumulation of noncalcified, avascular cartilage. We have investigated the changes in cell proliferation and enzyme activities within specific cell types in the growth plate of chickens with differing severity of the disease...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/8756-3282(92)90362-z
更新日期:1992-01-01 00:00:00
abstract::This study describes the early interface reaction of cancellous bone to a nanocrystalline hydroxyapatite cement containing type I collagen (HA/Coll) and its modifications with sodium citrate (CI), calcium carbonate (CA), phosphoserine (P) and phosphoserine plus RGD-peptide (RGD). Cylindrical implants of HA/Coll and it...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2006.11.019
更新日期:2007-04-01 00:00:00
abstract::Bone structure is the key to the understanding of fracture risk. The hypothesis tested in this prospective study is that dense mandibular trabeculation predicts low fracture risk, whereas sparse trabeculation is predictive of high fracture risk. Out of 731 women from the Prospective Population Study of Women in Gothen...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2011.06.036
更新日期:2011-10-01 00:00:00
abstract::The Euler number and the connectivity of an arbitrary object is defined, and it is illustrated why the connectivity of an n-dimensional object cannot be estimated in an (n-1)-dimensional section. The disector--principle for 3-D counting of the Euler--events is illustrated in cancellous bone. The correct handling for u...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/8756-3282(93)90144-y
更新日期:1993-05-01 00:00:00
abstract::In order to evaluate the effects of uremia and low levels of dietary phosphorus on bone, male Sprague-Dawley rats weighing 320 +/- 20 g (12 weeks old) were subjected to either a two-step, subtotal nephrectomy or sham-operation (SO), and then fed a custom diet with either normal calcium (0.5%) and normal phosphorus (0....
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/8756-3282(90)90070-f
更新日期:1990-01-01 00:00:00
abstract::Osteocytes, the most abundant cells in the cortical bone matrix, are thought to have mechanosensory and chemosensory regulatory roles. Marotti theorized that osteocytes signal to osteoblasts to recruit them into the osteocyte lineage. Martin extended this theory, assuming that osteocytes display a general inhibitory e...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/s8756-3282(03)00245-x
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVES:Osteoporosis results in loss of bone mass and microarchitectural deterioration. Dental radiographs potentially offer a means of screening for osteoporosis as they are commonly made on adults. Spatial frequency analyses are well suited to detect subtle changes in image patterns. We hypothesize that individual...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2004.03.002
更新日期:2004-08-01 00:00:00
abstract::Bone homeostasis is regulated by a balance of bone formation and bone resorption; dysregulation of bone homeostasis may cause bone-related diseases (e.g., osteoporosis, osteopetrosis, bone fracture). Members of the nuclear factor of activated T cells (NFAT) family of transcription factors play crucial roles in the reg...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2019.115153
更新日期:2020-02-01 00:00:00
abstract::Paramagnetic manganese can be employed as a calcium surrogate to sensitize the magnetic resonance imaging (MRI) technique to the processing of calcium during the bone formation process. At low doses, after just 48h of exposure, osteoblasts take up sufficient quantities of manganese to cause marked reductions in the wa...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2011.02.014
更新日期:2011-05-01 00:00:00
abstract::New methods to increase vertical bone growth are needed to permit dental implant placement in patients with low alveolar ridge height after extended periods of tooth loss. While ectopic rodent models are typically used to evaluate new osteogenic implant surface coatings, a more relevant intramembraneous rodent model w...
journal_title:Bone
pub_type: 杂志文章
doi:10.1016/j.bone.2008.05.021
更新日期:2008-10-01 00:00:00