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Type:	Artigo de Periódico
Title:	Negative impact of high cumulative glucocorticoid dose on bone metabolism of patients with myasthenia gravis
Authors:	Nayara Felicidade Tomazbraz Natalia Pessoa Rocha Érica Leandro Marciano Vieira Rodrigo Santiago Gomez Izabela Guimarães Barbosa Olívio Brito Malheiro Adriana Maria Kakehasi Antonio Lucio Teixeira
Abstract:	Abstract This current study aimed to evaluate the frequency of low bone mass, osteopenia, and osteoporosis in patients with myasthenia gravis (MG) and to investigate the possible association between bone mineral density (BMD) and plasma levels of bone metabolism markers. Eighty patients with MG and 62 controls BMD were measured in the right femoral neck and lumbar spine by dual-energy X-ray absorptiometry. Plasma concentrations of osteocalcin, osteopontin, osteopro tegerin, tumor necrosis factor (TNF-α), interleukin (IL)-1β, IL-6, dickkopf (DKK-1), sclerostin, insulin, leptin, adrenocorticotropic hormone, parathyroid hormone, and fibroblast growth factor (FGF-23) were analyzed by Luminex®. The mean age of patients was 41.9 years, with 13.5 years of length of illness, and a mean cumulative dose of glucocorticoids 38,123 mg. Patients had significant reduction in BMD of the lumbar, the femoral neck, and in the whole body when compared with controls. Fourteen percent MG patients had osteoporosis at the lumbar spine and 2.5% at the femoral neck. In comparison with controls, patients with MG presented lower levels of osteocalcin, adrenocorticotropic hormone, parathyroid hormone, sclerostin, TNF-α, and DKK-1 and higher levels of FGF-23, leptin, and IL-6. There was a significant negative correlation between cumulative glucocorticoid dose and serum calcium, lumbar spine T-score, femoral neck BMD,T-score, and Z-score. After multivariate analysis, higher TNF-α levels increased the likelihood of presenting low bone mass by 2.62. MG patients under corticotherapy presented low BMD and altered levels of bone markers.
Subject:	Miastenia Gravis Densidade Óssea Osteporose Absorciometria de Fóton
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	MED - DEPARTAMENTO DE APARELHO LOCOMOTOR MED - DEPARTAMENTO DE CLÍNICA MÉDICA MED - DEPARTAMENTO DE SAÚDE MENTAL
Rights:	Acesso Restrito
metadata.dc.identifier.doi:	10.1007/s10072-017-2964-z
URI:	http://hdl.handle.net/1843/56342
Issue Date:	9-May-2017
metadata.dc.url.externa:	https://link.springer.com/article/10.1007/s10072-017-2964-z
metadata.dc.relation.ispartof:	Neurological Sciences
Appears in Collections:	Artigo de Periódico

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