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Use of inhaled corticosteroids and bone mineral density in a population based study: the Nord-Trondelag Health Study (the HUNT Study)

Langhaminer, A; Norjavaara, E; de Verdier, MG; Johnsen, R and Bjermer, Leif LU (2004) In Pharmacoepidemiology and Drug Safety 13(8). p.569-579
Abstract
Conflicting results have been reported of the long-term effects of treatment with inhaled corticosteroids (ICS) on bone. The objective of this study was to compare ICS users and non-users regarding bone mineral density (BMD) in a large population. A total of 65 225 adults participated in a cross-sectional study in the Nord-Trondelag Health Study 1995-1997. Those reporting asthma or asthma-related symptoms, were invited to have bone densitometry of the forearm, flow volume spirometry and a personal interview. Altogether 4482 women and 4142 men participated, of whom 2113 reported ever use and 6511 never use of ICS. Never-users of corticosteroids had a mean BMD, adjusted for confounders (age, square age, sex, body mass index, height, physical... (More)
Conflicting results have been reported of the long-term effects of treatment with inhaled corticosteroids (ICS) on bone. The objective of this study was to compare ICS users and non-users regarding bone mineral density (BMD) in a large population. A total of 65 225 adults participated in a cross-sectional study in the Nord-Trondelag Health Study 1995-1997. Those reporting asthma or asthma-related symptoms, were invited to have bone densitometry of the forearm, flow volume spirometry and a personal interview. Altogether 4482 women and 4142 men participated, of whom 2113 reported ever use and 6511 never use of ICS. Never-users of corticosteroids had a mean BMD, adjusted for confounders (age, square age, sex, body mass index, height, physical activity, work load, packyears, family history of osteoporosis and in women number of years since menopause and use of hormone replacement therapy), of 0.493 g/cm(2) at the distal site. Subjects having only used ICS or combined with courses of prednisolone, had 0.008 g/cm(2) (95% Cl: 0.005-0.011) lower BMD whilst users of prednisolone greater than or equal to6 months had 0.038 g/cm(2) (0.021-0.055) lower level. No dose response association between ICS and BMD, or difference in BMD by type of ICS was found. The association between CS use and BMD was independent of the measuring site. ICS use was associated with lower BMD. The lack of dose response in this study might be due to a narrow dose range or indicates that other characteristics of the patient group are contributing to the observed difference in ICS users compared to never-users. Copyright (C) 2004 John Wiley Sons, Ltd. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
inhaled, forearm, cross-sectional study, pulmonary disease, chronic obstructive, asthma bone mineral density, corticosteroids, conicosteroids, single X-ray absorptiometry
in
Pharmacoepidemiology and Drug Safety
volume
13
issue
8
pages
569 - 579
publisher
John Wiley & Sons
external identifiers
  • wos:000223646400014
  • pmid:15317039
  • scopus:4544271615
ISSN
1053-8569
DOI
10.1002/pds.941
language
English
LU publication?
yes
id
e3cbe4fc-f955-40df-894e-c97cbb077064 (old id 267711)
date added to LUP
2007-10-24 08:02:38
date last changed
2017-01-01 05:07:26
@article{e3cbe4fc-f955-40df-894e-c97cbb077064,
  abstract     = {Conflicting results have been reported of the long-term effects of treatment with inhaled corticosteroids (ICS) on bone. The objective of this study was to compare ICS users and non-users regarding bone mineral density (BMD) in a large population. A total of 65 225 adults participated in a cross-sectional study in the Nord-Trondelag Health Study 1995-1997. Those reporting asthma or asthma-related symptoms, were invited to have bone densitometry of the forearm, flow volume spirometry and a personal interview. Altogether 4482 women and 4142 men participated, of whom 2113 reported ever use and 6511 never use of ICS. Never-users of corticosteroids had a mean BMD, adjusted for confounders (age, square age, sex, body mass index, height, physical activity, work load, packyears, family history of osteoporosis and in women number of years since menopause and use of hormone replacement therapy), of 0.493 g/cm(2) at the distal site. Subjects having only used ICS or combined with courses of prednisolone, had 0.008 g/cm(2) (95% Cl: 0.005-0.011) lower BMD whilst users of prednisolone greater than or equal to6 months had 0.038 g/cm(2) (0.021-0.055) lower level. No dose response association between ICS and BMD, or difference in BMD by type of ICS was found. The association between CS use and BMD was independent of the measuring site. ICS use was associated with lower BMD. The lack of dose response in this study might be due to a narrow dose range or indicates that other characteristics of the patient group are contributing to the observed difference in ICS users compared to never-users. Copyright (C) 2004 John Wiley Sons, Ltd.},
  author       = {Langhaminer, A and Norjavaara, E and de Verdier, MG and Johnsen, R and Bjermer, Leif},
  issn         = {1053-8569},
  keyword      = {inhaled,forearm,cross-sectional study,pulmonary disease,chronic obstructive,asthma bone mineral density,corticosteroids,conicosteroids,single X-ray absorptiometry},
  language     = {eng},
  number       = {8},
  pages        = {569--579},
  publisher    = {John Wiley & Sons},
  series       = {Pharmacoepidemiology and Drug Safety},
  title        = {Use of inhaled corticosteroids and bone mineral density in a population based study: the Nord-Trondelag Health Study (the HUNT Study)},
  url          = {http://dx.doi.org/10.1002/pds.941},
  volume       = {13},
  year         = {2004},
}