Relevant Research Of Bone Metabolism Of Glucocorticoid-induced Osteoporosis And The Duration Of Glucocorticoid Treatment

Objective:The objective of this study was to investigate the change of bone metabolism in different duration of glucocorticoid(GC)treatment of systemtic lupus erythematosus,and according to the trend of bone metabolic to explore the therapeutic schedule of glucocorticoid-induced osteoporosisi(GIOP).Method:1.This study included 117 cases of pre-menopausal women with SLE as the observation object and 21 cases of healthy pre-menopausal women as a control object.According to the duration of GC therapy,we divided the patients into seven subgroups.I group of 19 cases of GCs treatment ≤ 6 months,II group of 17 cases of GCs treantment7 to 12 months,III group of 18 cases of GCs treantment13 to 18 months,Ⅳ group of 16 cases of GCs treantment19 to 24 months,V group of 15 cases of GCs treantment25 to 30 months,VI group of 16 cases of GCs treantment31 to 36 months,Ⅶ group of 16 cases of GCs treatment>36 months.2.Serum biochemical markers of bone formation(amino-terminal-propeptide of type I collagen[T-PINT],amino-terminal of osteocalcin[N-MIDOs])and bone resorption(type Ⅰ collagen cross-linkde C-telopeptide degradation fragments[β-CTX])of all the groups members were measured in an enzyme-linked immunosorbent method(ELISA)and electrochemiluminescent immunoassay(ECLI).3.Bone mineral density(BMD)of the lumbar spine(L1-L4)were measured by dual-energy X-ray absorptiometry(Hologic/Discovery-Wi,USA).To reflect the changes of bone mass with bone mineral density.4.The date were analyzed and contrast by statistics.Statistical analyses were performed using SPSS software,version 19.0(?).Result:As the extension of duration,it is a regular change of bone metabolism.the change of bone metabolism is from the high decomposition to low decomposition and low osteogenesis in the process of GIOP formation.Details are as follows:①.The serum(3-CTX of the patients with GC therapy within 18-months was significantly higher than the control group(P<0.05).②.There were no significant differences in β-CTX between the patients with GCs treatment 19 to 30 months and control group(P>0.05).③.The serum β-CTX of the patients with GC therapy more than 30-months was significantly lower than the control group(P<0.05).④.The serum T-PINT and N-MIDOs of all subgroups of patients were significantly lower than the control group(P<0.05).④.The BMD of the patients with GC therapy more than 6-months was significantly lower than the control group(P<0.05).Conclusion:In conclusion,the change of bone metabolism is from the high decomposition to low decomposition and low osteogenesis in the process of GIOP formation.For the prevention and treatment of the GIOP we shoud take effective sequential treatment,the therapies of the patients with GC therapy within 18-months should be given priority to inhibit bone resorption,the therapies of the patients with GC therapy over 18-months should be given priority to promote bone formation.