Evidence map›Paper›PMID 29947865›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018

Abnormal microarchitecture and stiffness in postmenopausal women using chronic inhaled glucocorticoids.

Y Liu, E Dimango, M Bucovsky, S Agarwal, K Nishiyama, X E Guo, E Shane, E M Stein

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.6field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 14 citations in OpenAlex.

  1. Effect of Denosumab Compared With Risedronate on Bone Strength in Patients Initiating or Continuing Glucocorticoid Treatment.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2022
    Trial
  2. Review
  3. A Pilot Study of the Gut Microbiota in Spine Fusion Surgery Patients.HSS journal : the musculoskeletal journal of Hospital for Special Surgery · 2025
    Article
  4. Review
  5. Review
  6. The clinical application of high-resolution peripheral computed tomography (HR-pQCT) in adults: state of the art and future directions.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2021
    Review
  7. Article
  8. Article
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Y LiuDivision of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA.
E DimangoDivision of Pulmonology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
M BucovskyDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
S AgarwalDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
K NishiyamaDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
X E GuoBone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY, USA.
E ShaneDivision of Endocrinology, Columbia University College of Physicians and Surgeons, New York, NY, USA.
E M SteinDivision of Endocrinology and Metabolic Bone Disease, Hospital for Special Surgery, Weill Cornell Medical College, 535 East 70th Street, New York, NY, 10021, USA. steine@hss.edu.
Columbia University · USHospital for Special Surgery · US

Funding

Micro-Mechanical Modeling of Trabecular BoneR01AR051376 · NIAMS · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI GUO, X. EDWARD · 2006 to 2015
$3.2M
Chronic Kidney Disease and PTH: Effects on the Postmenopausal SkeletonK23DK084337 · NIDDK · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI STEIN, EMILY MARGARET · 2009 to 2013
$749k
Ultra-high Resolution pQCT as a Biomarker of Bone Strength in Osteoporosis TrialsU01AR055068 · NIAMS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI SHANE, ELIZABETH J · 2007 to 2010
$644k
National Institutes of Health K23 DK084337National Institutes of Health U01 AR055968NIAMS NIH HHS R01 AR051376NIAMS NIH HHS U01 AR055068NIDDK NIH HHS K23 DK084337
6 · The paper itself

Abstract

Postmenopausal (PM) women using inhaled glucocorticoids (IGCs) had substantial abnormalities in volumetric BMD (vBMD), microarchitecture, and stiffness using high resolution peripheral computed tomography (HRpQCT) compared to age- and race-matched controls. Abnormalities were most severe at the radius. These preliminary results suggest that there may be major, heretofore unrecognized, skeletal deficits in PM women using IGCs.

introductionWhile oral glucocorticoids are well recognized to have destructive skeletal effects, less is known about the effects of IGCs. The detrimental skeletal effects of IGCs may be greatest in PM women, in whom they compound negative effects of estrogen loss and aging. The goal of this study was to evaluate microarchitecture and stiffness in PM women using chronic IGCs.

methodsThis case-control study compared PM women using IGCs for ≥ 6 months (n = 20) and controls matched for age and race/ethnicity (n = 60). Skeletal parameters assessed included areal BMD (aBMD) by DXA, trabecular and cortical vBMD and microarchitecture by HRpQCT of the radius and tibia, and whole bone stiffness by finite element analysis.

resultsBy DXA, mean values in both groups were in the osteopenic range; hip aBMD was lower in IGC users (P < 0.04). By HRpQCT, IGC users had lower total, cortical, and trabecular vBMD at both radius and tibia (all P < 0.05). IGC users had lower cortical thickness, lower trabecular number, greater trabecular separation and heterogeneity at the radius (all P < 0.03), and greater heterogeneity at the tibia (P < 0.04). Whole bone stiffness was lower in IGC users at radius (P < 0.03) and tended to be lower at the tibia (P = 0.09).

conclusionsPM women using IGCs had substantial abnormalities in vBMD, microarchitecture, and stiffness compared to controls. These abnormalities were most severe at the radius. These preliminary results suggest that there may be major, heretofore unrecognized, skeletal deficits in PM women using IGCs.

Indexed as

Absorptiometry, PhotonAdministration, InhalationAgedBone DensityCase-Control StudiesDrug Administration ScheduleElasticityFemaleGlucocorticoidsHumansMiddle AgedOsteoporosis, PostmenopausalRadiusTibiaTomography, X-Ray ComputedGlucocorticoidsBone qualityInhaled glucocorticoidsMicroarchitectureOsteoporosis

Identifiers

PMID29947865
PMCPMC6138454
OpenAlexW2808332074

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.