Journal of Obesity & Metabolic Syndrome

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Korean J Obes 2008; 17(4): 162-168

Published online December 1, 2008

Copyright © Korean Society for the Study of Obesity.

Trends of Korean and International Medical Research about Obesity

Chang Beom Lee*

Department of Internal Medicine, Hanyang University Medical College

Abstract

Background: To evaluate effect of calcitrtiol on the
bone mineral density changes after weight reduction of
obese patients with glucocorticoid induced osteoporosis.
Methods: The study sample consisted of the
glucocorticoid group, which included 53 females (age:
60.3 ± 5.9 yr) who were taking glucocorticoid and were
being followed up at our hospital for rheumatoid arthritis
and osteoarthritis, and the control group, which included
50 females (age: 59.3 ± 3.0 yr) who had the same
diseases but were not on glucocorticoid. All of the
patients from the glucocorticoid group were taking
triamcinolone in dose greater than 2 mg/day for more than
6 months for rheumatoid arthritis. Patients from both
groups received obesity treatment for knee joint pain, and
also calcitriol 0.25 μg and calcium 1,000 mg. The effects
of those drugs were evaluated by annual QCT
(Quantitative Computed Tomography) measurement of
BMD (Bone mineral density).
Results: There was no significant difference in the
initial BMD between the control and the glucocorticoid
group (75.9 vs 70.1 mg/cm2, P > 0.05). No significant
improvement in BMD was noted in either group since the
initial treatment until after a year, even when analyzed in
terms of different age groups. After one year of treatment,
the percentages of patients with a decrease in BMD of
over 3% in the age groups of less than 60 years for
control group and glucocorticoid group were 30% and
38%, respectively (P > 0.05). However, among the age
groups of 60 and above, 44% of the glucocorticoid group
showed a decrease in BMD of greater than 3% compared
to 33% of the control group. Therefore, a significantly
higher ratio of patients from the glucocorticoid group
showed a decrease in BMD compared to the control
group after the age of 59 (P < 0.05).
Conclusion: The patient’s age must be taken into
consideration when deciding the use of glucocorticoid in
rheumatoid arthritis patients, The antiresorptive calcitriol
did not protect against the harmful effects of
glucocorticoid. Further studies involving larger study

Keywords: Obesity, Glucocorticoid induced osteoporosis, Calcitriol