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Renal transplant recipients (RTR) are at increased risk of osteoporosis (OP) due to long-term glucocorticoid use and other risk factors. Glucocorticoid induced OP, unlike postmenopausal OP may be less influenced by gender or hormonal status. The objective of this study was to evaluate the risk factors for glucocorticoid induced OP at the hip and spine in RTR, with an emphasis on gender and menopausal status. The degree of OP was graded by the standard deviation (SD) in a patient's bone mineral density (BMD) compared to a normal adults peak bone mass (T-score). The WHO defines OP and osteopenia in terms of T-scores of >2.5 SD and >1.5 SD below the mean respectively. Thirty-one consecutive renal transplant patients evaluated in the nephrology clinics at least six months post transplant received a BMD scan by dual energy x-ray absorptiometry between October and December 1997. A retrospective chart review was performed to assess the frequency of possible risk factors, including demographics, laboratory parameters, glucocorticoid history, medical history, physical activity and gonadal status. Fisher's exact test and Kruskal-Wallis Chi-square approximations were used to compare groups (p<O.05). The results (mean+SD) are summarized in the table.
As expected, higher body weight was a protective factor in the severity of glucocorticoid induced OP. However, neither gender nor menopausal status supplied an expected protective benefit. Our results suggest that all patients, regardless of age, gender or hormonal status should be considered as candidates for OP prevention.