{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:30:05Z","timestamp":1793845805848,"version":"4.6.1"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[1998,3,1]],"date-time":"1998-03-01T00:00:00Z","timestamp":888710400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Osteoporosis is a major complication of long-term corticosteroid administration, but the magnitude of the effect in patients with chronic obstructive pulmonary disease (COPD) is not well defined. In a cross-sectional study, we evaluated the association between steroid use and vertebral fractures in 312 men, 50 yr of age or older, with COPD. Subjects were evaluated according to their corticosteroid use: Never Steroid Users (NSU) (n = 117), Inhaled Steroid Users (ISU) (n = 70), and Systemic Steroid Users (SSU) (n = 125). The prevalence of one or more vertebral fractures was 48.7% in the NSU group, 57.1% in the ISU group, and 63.3% in the SSU group. Compared with NSU, SSU were two times as likely to have one or more vertebral fractures: age-adjusted odds ratio (OR) = 1.80; 95% CI, 1.08 to 3.07. This relationship was primarily due to a strong association between continuous systemic steroid use and vertebral fractures: age-adjusted OR = 2.36; 95% CI, 1.26 to 4.38. In addition, fractures in SSU were more likely to be multiple and more severe. A weaker relationship existed between inhaled steroid use and vertebral fractures: age-adjusted OR = 1.35; 95% CI, 0.77 to 2.56 compared with NSU. These data indicate that vertebral fractures are common in older men with COPD; the likelihood of these fractures is greatest in those men using continuous systemic steroids. McEvoy CE, Ensrud KE, Bender E, Genant HK, Yu W, Griffith JM, Niewoehner DE. Association between corticosteroid use and vertebral fractures in older men with chronic obstructive pulmonary disease.<\/jats:p>","DOI":"10.1164\/ajrccm.157.3.9703080","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T13:33:32Z","timestamp":1365082412000},"page":"704-709","source":"Crossref","is-referenced-by-count":216,"title":["Association between Corticosteroid Use and Vertebral Fractures in Older Men with Chronic Obstructive Pulmonary Disease"],"prefix":"10.1093","volume":"157","author":[{"given":"CHARLENE E.","family":"McEVOY","sequence":"first","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"KRISTINE E.","family":"ENSRUD","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"EARL","family":"BENDER","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HARRY K.","family":"GENANT","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"WEI","family":"YU","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JAYNE M.","family":"GRIFFITH","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DENNIS E.","family":"NIEWOEHNER","sequence":"additional","affiliation":[{"name":"Section of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Minnesota Medical School; Sections of General Internal Medicine and Pulmonary Medicine, Department of Medicine, and Department of Radiology, VA Medical Center; Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, Minnesota; and Departments of Radiology and Medicine, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1998,3,1]]},"reference":[{"key":"2026032709122320100_B1","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1172\/JCI110570","article-title":"Differential effects of endocrine dysfunction on the axial and appendicular skeleton.","volume":"69","author":"Seeman","year":"1982","journal-title":"J. Clin. Invest"},{"key":"2026032709122320100_B2","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1016\/S0300-595X(73)80048-9","article-title":"Corticosteroid osteoporosis.","volume":"2","author":"Gallagher","year":"1973","journal-title":"Clin. Endocrinol. Metab"},{"key":"2026032709122320100_B3","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1016\/0039-128X(91)90117-E","article-title":"Glucocorticoid-induced osteoporosis: a cross-sectional study.","volume":"56","author":"Brandli","year":"1991","journal-title":"Steroids"},{"key":"2026032709122320100_B4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/BF01624152","article-title":"Risk of osteoporosis in men with chronic bronchitis.","volume":"2","author":"Praet","year":"1992","journal-title":"Osteoporos. Int"},{"key":"2026032709122320100_B5","doi-asserted-by":"crossref","first-page":"963","DOI":"10.7326\/0003-4819-119-10-199311150-00001","article-title":"Low-dose prednisone induces rapid reversible axial bone loss in patients with rheumatoid arthritis.","volume":"119","author":"Laan","year":"1993","journal-title":"Ann. Intern. Med"},{"key":"2026032709122320100_B6","first-page":"456","article-title":"Elevated 1,25-dihydroxyvitamin D levels in patients with chronic obstructive pulmonary disease treated with prednisone.","volume":"76","author":"Bikle","year":"1993","journal-title":"J. Clin. Endocrinol. Metab"},{"key":"2026032709122320100_B7","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1001\/archinte.1990.00390230093012","article-title":"Determinants of vertebral mineral density in patients receiving long-term glucocorticoid therapy.","volume":"150","author":"Reid","year":"1990","journal-title":"Arch. Intern. Med"},{"key":"2026032709122320100_B8","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1002\/jbmr.5650071120","article-title":"Vertebral deformity in men.","volume":"7","author":"Mann","year":"1992","journal-title":"J. Bone Miner. Res"},{"key":"2026032709122320100_B9","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1056\/NEJM198308043090502","article-title":"Steroid-induced fractures and bone loss in patients with asthma.","volume":"309","author":"Adinoff","year":"1983","journal-title":"N. Engl. J. Med"},{"key":"2026032709122320100_B10","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1136\/thx.42.12.962","article-title":"Vertebral compression fractures and mineral metabolism in chronic obstructive lung disease.","volume":"42","author":"Riancho","year":"1987","journal-title":"Thorax"},{"key":"2026032709122320100_B11","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1164\/ajrccm\/136.5.1285","article-title":"Standardization of spirometry: 1987 update. ATS statement.","volume":"136","author":"American Thoracic Society","year":"1987","journal-title":"Am. Rev. Respir. Dis"},{"key":"2026032709122320100_B12","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1378\/chest.85.6.751","article-title":"The measurement of dyspnea contents, interobserver agreement, and physiologic correlations of two new clinical indexes.","volume":"85","author":"Mahler","year":"1984","journal-title":"Chest"},{"key":"2026032709122320100_B13","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1097\/00005650-198807000-00007","article-title":"The MOS short-form general health survey: reliability and validity in a patient population.","volume":"26","author":"Stewart","year":"1988","journal-title":"Med. Care"},{"key":"2026032709122320100_B14","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1002\/jbmr.5650080915","article-title":"Vertebral fracture assessment using a semiquantitative technique.","volume":"8","author":"Genant","year":"1993","journal-title":"J. Bone Miner. Res"},{"key":"2026032709122320100_B15","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/0169-6009(89)90012-3","article-title":"Spinal osteoporosis in men.","volume":"5","author":"Francis","year":"1989","journal-title":"Bone Miner"},{"key":"2026032709122320100_B16","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/oxfordjournals.epirev.a036281","article-title":"Epidemiology of osteoporosis and osteoporotic fractures.","volume":"7","author":"Cummings","year":"1985","journal-title":"Epidemiol. Rev"},{"key":"2026032709122320100_B17","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1093\/ageing\/23.5.388","article-title":"A community-based population study of vertebral fractures in 85-yr-old men and women.","volume":"23","author":"Johansson","year":"1994","journal-title":"Age Ageing"},{"key":"2026032709122320100_B18","doi-asserted-by":"crossref","first-page":"198","DOI":"10.3109\/17453679209154823","article-title":"Determinates of osteoporotic thoracic vertebral fracture: screening of 57,000 Finnish women and men.","volume":"63","author":"Santavirta","year":"1992","journal-title":"Acta Orthop. Scand"},{"key":"2026032709122320100_B19","first-page":"137","article-title":"The basophil adenomas of the pituitary body and their clinical manifestations.","volume":"50","author":"Cushing","year":"1932","journal-title":"Bull. Johns Hopkins Hosp"},{"key":"2026032709122320100_B20","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1001\/archinte.1976.03630030032007","article-title":"Osteoporosis of the slender smoker: vertebral compression fractures and loss of metacarpal cortex in relation to postmenopausal cigarette smoking and back of obesity.","volume":"136","author":"Daniell","year":"1976","journal-title":"Arch. Intern. Med"},{"key":"2026032709122320100_B21","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/0002-9343(83)90878-1","article-title":"Risk factors for spinal osteoporosis in men.","volume":"75","author":"Seeman","year":"1983","journal-title":"Am. J. Med"},{"key":"2026032709122320100_B22"},{"key":"2026032709122320100_B23","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1002\/jbmr.5650070214","article-title":"Incidence of clinically diagnosed vertebral fractures: a population-based study in Rochester, Minnesota, 1985\u201389.","volume":"7","author":"Cooper","year":"1992","journal-title":"J. Bone Miner. Res"},{"key":"2026032709122320100_B24","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/BF02556362","article-title":"Changes in incidence and prevalence of vertebral fractures during 30 years.","volume":"42","author":"Bengner","year":"1988","journal-title":"Calcif. Tissue Int"},{"key":"2026032709122320100_B25","first-page":"S129","article-title":"Prevalence and incidence of vertebral fractures in the elderly: initial results from the Framingham study.","volume":"9","author":"Kiel","year":"1995","journal-title":"J. Bone Miner. Res"},{"key":"2026032709122320100_B26","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1002\/art.1780380705","article-title":"Markers of bone metabolism in postmenopausal women with rheumatoid arthritis.","volume":"38","author":"Hall","year":"1995","journal-title":"Arthritis Rheum"},{"key":"2026032709122320100_B27","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1378\/chest.110.4.867-a","article-title":"Systemic corticosteroids in COPD: an unresolved clinical dilemma.","volume":"110","author":"Niewoehner","year":"1996","journal-title":"Chest"}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/157\/3\/704\/67445526\/ajrccm_157_3_704.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/157\/3\/704\/67445526\/ajrccm_157_3_704.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:12:30Z","timestamp":1774617150000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/157\/3\/704\/8531060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,3,1]]},"references-count":27,"journal-issue":{"issue":"3","published-online":{"date-parts":[[1998,3,1]]},"published-print":{"date-parts":[[1998,3,1]]}},"URL":"https:\/\/doi.org\/10.1164\/ajrccm.157.3.9703080","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1998,3]]},"published":{"date-parts":[[1998,3,1]]}}}