Negative impact of high cumulative glucocorticoid dose on bone metabolism of patients with myasthenia gravis
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Universidade Federal de Minas Gerais
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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.
Abstract
Assunto
Miastenia Gravis, Densidade Óssea, Osteporose, Absorciometria de Fóton
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Myasthenia gravis, Bone mineral density, Bone metabolism markers, Osteoporosis, Dual-energy X-ray absorptiometry
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https://link.springer.com/article/10.1007/s10072-017-2964-z