open access

Vol 85, No 1 (2017)
ORIGINAL PAPERS
Submitted: 2017-02-13
Accepted: 2017-02-13
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Corticosteroids and hip fracture risk in elderly respiratory patients: EPIC-Greece cohort

Anna Karakatsani, Michail Katsoulis, Eleni Klinaki, Antonia Trichopoulou
DOI: 10.5603/ARM.2017.0005
·
Adv Respir Med 2017;85(1):22-27.

open access

Vol 85, No 1 (2017)
ORIGINAL PAPERS
Submitted: 2017-02-13
Accepted: 2017-02-13

Abstract

INTRODUCTION: In an ageing population the prevalence of osteoporosis and chronic respiratory diseases is expected to increase in the near future. Interestingly, several forms of corticosteroids, drugs implicated in osteoporosis pathogenesis, are prescribed to respiratory patients without taking into consideration their age and risk for osteoporotic fractures. The aim of this study was to investigate the risk for hip fracture of the elder individuals who are taking corticosteroids for respiratory disease, including inhalers.

MATERIAL AND METHODS: Data on incident hip fractures were collected through the active follow-up for all individuals participating in the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC-Greece) study who were 60 years or older at recruitment and reported “a doctor’s diagnosis” of respiratory disease. Socio-demographic, life-style, health status data and use of corticosteroids were recorded from the baseline and follow-up questionnaires. Cox regression models were applied to estimate hazard ratios (HRs) adjusting for relevant confounders.

RESULTS: We observed an increase in hip fracture risk with corticosteroid intake overall (HR: 1.68, 95% CI: 0.85–3.34). Increased risk persisted when we restricted our analysis to participants taking any form of corticosteroids for obstructive lung disease (HR: 1.40, 95% CI: 0.64–3.06) and to those using only inhalers (HR: 1.58, 95% CI: 0.71–3.50). However, these positive associations did not reach the nominal level of significance probably due to the small number of participants with hip fractures during follow-up.

CONCLUSION: Hip fracture risk should be taken into consideration when recommending corticosteroids to the elder respiratory patients, including inhalers.

Abstract

INTRODUCTION: In an ageing population the prevalence of osteoporosis and chronic respiratory diseases is expected to increase in the near future. Interestingly, several forms of corticosteroids, drugs implicated in osteoporosis pathogenesis, are prescribed to respiratory patients without taking into consideration their age and risk for osteoporotic fractures. The aim of this study was to investigate the risk for hip fracture of the elder individuals who are taking corticosteroids for respiratory disease, including inhalers.

MATERIAL AND METHODS: Data on incident hip fractures were collected through the active follow-up for all individuals participating in the Greek segment of the European Prospective Investigation into Cancer and Nutrition (EPIC-Greece) study who were 60 years or older at recruitment and reported “a doctor’s diagnosis” of respiratory disease. Socio-demographic, life-style, health status data and use of corticosteroids were recorded from the baseline and follow-up questionnaires. Cox regression models were applied to estimate hazard ratios (HRs) adjusting for relevant confounders.

RESULTS: We observed an increase in hip fracture risk with corticosteroid intake overall (HR: 1.68, 95% CI: 0.85–3.34). Increased risk persisted when we restricted our analysis to participants taking any form of corticosteroids for obstructive lung disease (HR: 1.40, 95% CI: 0.64–3.06) and to those using only inhalers (HR: 1.58, 95% CI: 0.71–3.50). However, these positive associations did not reach the nominal level of significance probably due to the small number of participants with hip fractures during follow-up.

CONCLUSION: Hip fracture risk should be taken into consideration when recommending corticosteroids to the elder respiratory patients, including inhalers.

Get Citation

Keywords

elderly, EPIC-Greece, corticosteroids, hip fracture, respiratory disease

About this article
Title

Corticosteroids and hip fracture risk in elderly respiratory patients: EPIC-Greece cohort

Journal

Advances in Respiratory Medicine

Issue

Vol 85, No 1 (2017)

Pages

22-27

DOI

10.5603/ARM.2017.0005

Bibliographic record

Adv Respir Med 2017;85(1):22-27.

Keywords

elderly
EPIC-Greece
corticosteroids
hip fracture
respiratory disease

Authors

Anna Karakatsani
Michail Katsoulis
Eleni Klinaki
Antonia Trichopoulou

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