Background Lately the effect of corticosteroids on BMD during different diseases including autoimmunic ones was widely discussed.
Objectives To determine the effect of long-term (>5 years) taking of Prednisolone in daily dosage of 2–2.5 mg on BMD in pts with Sjogren’s syndrome (SS).
Methods 112 female pts aged 33–73 with reliable SS diagnosis were examined. 56 (50%) out of them were treated for more then 5 years by low doses of hormones. As it was evident that menopausal beginning influenced BMD, all examined persons were divided into 4 groups: pts with retained menstrual cycle who did not receive hormones (1st group – 32pts with median age 40.7(7.8 years) and those who for a long time took low doses (<5 mg/day) of Prednisolone (2nd group – 24 pts with median age 41.5(4.7 years); women of postmenopausal period who were never treated by hormones (3d group – 24 pts aged 57.5(6.7 year, postmenopausal period 7.3(0.8 years) and those who for a long time took low doses of Prednisolone (4th group – 32 pts aged 52.3(5.6 years; postmenopausal period 8.1(0.7 years). All groups of pts were comparable by weight and height coefficient. Assessment of BMD in lumbar area of the spine (L1-L4) and left femoral neck was carried out by double X-ray absorptiometry on densitometer QDR-1000 («Hologic», USA). Statistical analysis was done by Student’s t-criterion and (2 criterion).
Results BMD in L1-L4 was correspondingly to 1–4 groups: 1.030(0.128 g/cm2, 0.983(0.100 g/cm2, 0.858(0.123 g/cm2 and 0.837(0.124 g/cm2, there were no reliable difference in comparison of 1st and 2nd, 3d and 4th groups. BMD in femoral neck was as follows according to groups: 0.891(0.115 g/cm2, 0.815(0.104 g/cm2, 0.740(0.116 g/cm2 and 0.763(0.090 g/cm2. During analysis it turned out that BMD in femoral neck in the 2nd group was reliably lower than in the 1st group (t = 2.59, p < 0.01), during comparison of the 3d and 4th group there were no differences. In the 1st and 2nd groups there was no osteoporosis (T <2.5 SD), osteopenia (T <1.0 SD) in L1-L4 and in neck developed correspondingly in 25% and 18.75% of cases in the1st group and in 33.3% and 41.7% in the 2nd group. In the 3d and 4th groups osteoporosis and osteopenia developed mainly with equal frequency in corresponding areas.
Conclusion In women with retained menstrual cycle the long-term taking of low doses of Prednisolone results in BMD decrease in femoral neck, frequency of osteopenia grows but osteoporosis in this case does not develop. In postmenopausal period taking of low doses of hormones has no substantial effect on the frequency of osteoporosis and osteopenia development.
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