Vertebral fracture and cortical bone changes in corticosteroid-induced osteoporosis

H. Tsugeno, H. Tsugeno, T. Fujita, B. Goto, T. Sugishita, Y. Hosaki, Kozo Ashida, Fumihiro Mitsunobu, Y. Tanizaki, Y. Shiratori

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Despite an intriguing understanding of trabecular bone dynamics, little is known about corticosteroid-induced cortical bone loss and fractures. Recently, we verified a steroid-induced decrease in cortical bone volume and density using peripheral quantitative computed tomography (pQCT) in adult asthmatic patients given oral corticosteroids. Subsequently, the pQCT parameters and presence of vertebral fractures were investigated to further clarify the role of cortical bone quality in fractures in 86 postmenopausal (>5 years after menopause) asthmatic patients on high-dose oral steroid (>10 g cumulative oral prednisolone) (steroid group) and 194 age-matched controls (control group). Cortical and trabecular bone was subjected to measurement of various parameters using pQCT (Stratec XCT960). Relative Cortical Volume (RCV) was calculated by dividing the cortical area by the total bone area. Strength Strain Index (SSI) was determined in the radius based on the density distribution around the axis. Spinal fracture was assessed on lateral radiographs. Patients treated with high doses of oral steroid (>10 g cumulative oral prednisolone) were found to have an increased risk of fracture compared with control women receiving no steroid medication (odds ratio, 8.85; 95% CI, 4.21-18.60) after adjustment was made for years since menopause, body mass index and RCV. In both groups, the diagnostic and predictive ability of the pQCT parameters for vertebral fracture was assessed by the areas under their receiver operating characteristic (ROC) curves. All parameters were found to be significant predictors (p

Original languageEnglish
Pages (from-to)650-656
Number of pages7
JournalOsteoporosis International
Issue number8
Publication statusPublished - 2002



  • Cortical bone
  • Corticosteroid
  • Peripheral quantitative computed tomography
  • Vertebral fracture

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Tsugeno, H., Tsugeno, H., Fujita, T., Goto, B., Sugishita, T., Hosaki, Y., Ashida, K., Mitsunobu, F., Tanizaki, Y., & Shiratori, Y. (2002). Vertebral fracture and cortical bone changes in corticosteroid-induced osteoporosis. Osteoporosis International, 13(8), 650-656.