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Osteoporosis in the at-risk asthmatic

机译：骨质疏松症在风险哮喘哮喘

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摘要

The effect of inhaled glucocorticosteroids (ICS) on bone metabolism and subsequent osteoporosis is controversial. Explanations for this controversy include various study designs, duration of use, outcome measures, and population demographics of research studies with intranasal or inhalational ICS. Patients with poorly controlled asthma are at greatest risk of osteoporosis because they are commonly treated with intermittent or continuous systemic corticosteroids (SCS) or high-dose ICS. A 45-year-old Caucasian woman presents with moderate-to-severe asthma with frequent albuterol use and nighttime awakenings at least once weekly. She is on fluticasone/salmeterol 500/50 μg one inhalation twice daily and montelukast 10 mg/day. She requires prednisone 15 mg three times per day for 5 days up to three times a year. Is this patient at greater risk of osteopenia, characterized by a T-score between -1.0 and -2.5, and subsequent osteoporosis and an increased risk of fractures? If she has osteopenia, should she be treated with a bisphosphonate? The risk of osteoporosis and fracture increases significantly with frequent administration of SCS, and patients on such medications should undergo preventative measures and treatment. This study discuses factors that contribute to an increased risk of osteoporosis/osteopenia in patients with asthma and suggests recommendations based on the current literature.
机译：吸入的糖皮质激素（IC）对骨代谢和随后的骨质疏松症的影响是有争议的。对此争议的解释包括各种研究设计，使用的持续时间，结果测量和具有鼻内或吸入IC的研究研究的人口统计学。哮喘较低的患者是最大的骨质疏松症的风险，因为它们通常用间歇或连续的全身皮质类固醇（SCS）或高剂量IC处理。一名45岁的白种人女性呈现出中度至严重的哮喘，至少每周至少一次常时令人震惊。她在氟络石/萨米特洛尔500/50μg每日一次吸入，蒙特洛特10毫克/天。她每天需要泼尼松15毫克，每年持续5天。这种患者是否具有更大的骨质脑风险，其特征在于-1.0和-2.5之间的T分，以及随后的骨质疏松症和骨折的风险增加？如果她有骨质增生，她应该用双膦酸盐治疗吗？骨质疏松症和骨折的风险显着随着SCS频繁施用而显着增加，并且在此类药物上的患者应进行预防措施和治疗。这项研究消除了患有哮喘患者骨质疏松症/骨质增强风险的因素，并提出了基于当前文献的建议。

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  • 来源
    《Allergy》 |2014年第11期|共11页
  • 作者

    AljubranS.A.; WhelanG.J.; GlaumM.C.; LockeyR.F.;

  • 作者单位

    Department of Internal Medicine Morsani College of Medicine University of South FloridaTampa FL;

    Department of Internal Medicine Morsani College of Medicine University of South FloridaTampa FL;

    Department of Internal Medicine Morsani College of Medicine University of South FloridaTampa FL;

    Department of Internal Medicine Morsani College of Medicine University of South FloridaTampa FL;

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  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 医学免疫学;
  • 关键词

    asthma; bisphosphonates; glucocorticoids; osteoporosis;

    机译：哮喘;双膦酸盐;糖皮质激素;骨质疏松症;

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