{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:24:32Z","timestamp":1793157872354,"version":"4.5.0"},"reference-count":44,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,8,14]],"date-time":"2020-08-14T00:00:00Z","timestamp":1597363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"Societat Catalana de Reumatologia","doi-asserted-by":"publisher","award":["MSD 2017\u20132018 grant"],"award-info":[{"award-number":["MSD 2017\u20132018 grant"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,8,10]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of this study was to identify the risk factors associated with fragility fracture (FF) development in glucocorticoid (GC)-treated patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>127 patients (aged 62\u00b118\u00a0years, 63% women) on GC-treatment (mean dose 14.5\u00b114.1 mg\/day and duration 47.7\u00b169\u00a0months) were included. The clinical data collected included bone metabolism study (including gonadal axis), GC-treatment, disease activity, dual-energy X-ray absorptiometry analysis (evaluating densitometric osteoporosis (OP) and trabecular bone score (TBS) degraded microarchitecture values (DMA)), X-ray (assessing vertebral fractures (VF)), FRAX risk (GC-adjusted) and previous FF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>17% of the patients had VF, 28% FF (VF and\/or non-VF), 29% OP and 52% DMA. Patients with VF received more GC boluses (57.1% vs 29.5%, p=0.03), were older (68\u00b113 vs 60\u00b119\u00a0years, p=0.02), postmenopausal (100% vs 67%, p=0.02), had low testosterone levels (57% vs 11%, p=0.02), lower TBS values (1.119\u00b10.03 vs 1.237\u00b10.013, p&lt;0.001) and higher FRAX risk (17.2\u00b116 vs 9.3\u00b17.6, p=0.003). Patients with FF showed higher accumulated GC doses (16.6\u00b118.4 vs 11.1\u00b112.9\u00a0g, p=0.046). On multivariate analysis, hypogonadism (OR 12.38; 95% CI 1.85 to &gt;100, p=0.01) and having received GC boluses (OR 3.45; 95% CI 1.04 to 12.15, p=0.01) were the main factors related to VF. Hypogonadism (OR 7.03; 95% CI 1.47 to 38.37, p=0.01) and FRAX &gt;20 (OR 7.08; 95% CI 1.28 to 53.71, p=0.02) were factors related to FF.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Hypogonadism is the principal risk factor for developing fractures in GC-treated men and women, whereas receiving GC boluses is a major factor for VF. These results indicate the importance of evaluating the gonadal axis in these patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001355","type":"journal-article","created":{"date-parts":[[2020,9,11]],"date-time":"2020-09-11T07:30:12Z","timestamp":1599809412000},"page":"e001355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Vertebral fracture risk in glucocorticoid-induced osteoporosis: the role of hypogonadism and corticosteroid boluses"],"prefix":"10.1136","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-5634","authenticated-orcid":false,"given":"Helena","family":"Florez","sequence":"first","affiliation":[{"name":"Metabolic Bone Diseases Unit, Department of Rheumatology, IDIBAPS, CIBERehd, University of Barcelona, Hospital Cl\u00ednic de Barcelona, Spain"},{"name":"Department of Rheumatology, University of Barcelona, Hospital Cl\u00ednic de Barcelona, 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