Abstract: 【Abstract】 Objective To investigate the incidence of and risk factors for osteoporosis in patients with pemphigus treated with systemic glucocorticoids, and to analyze the current status of prevention and treatment of osteoporosis. Methods Clinical data were collected from 101 inpatients with pemphigus treated in Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from January 2014 to January 2019, and these patients were divided into osteoporosis group （n = 21） and non-osteoporosis group （n = 80） according to their bone mineral density （BMD） values. Correlations of osteoporosis with patients′ general information, treatment duration and cumulative dose of glucocorticoids, application of immunosuppressive agents, diabetes mellitus, hypertension, hyperlipidemia, smoking, outdoor activity and other factors were analyzed, and the application status of calcium supplements, vitamin D and bisphosphonates was also analyzed. Enumeration data were compared by using chi-square test, measurement data were compared by using t test, and multiple factors influencing osteoporosis were analyzed by using non-conditional Logistic regression analysis. Results Logistic regression analysis showed that age （P = 0.001, OR = 1.08, 95% CI: 1.03 - 1.14） and cumulative dose of glucocorticoids （P ＜ 0.001, OR = 1.72, 95%CI: 1.18 - 2.52） were risk factors for the occurrence of osteoporosis, while outdoor activity （P ＜ 0.001, OR = 0.04, 95%CI: 0.01 - 0.21） was a protective factor. Moreover, 13 （61.9%） patients in the osteoporosis group and 16 （21.6%） patients in the non-osteoporosis group received combination treatment with calcium supplements, vitamin D and bisphosphonates. Conclusions Pemphigus patients treated with systemic glucocorticoids are prone to develop osteoporosis. Older age, cumulative dose of glucocorticoids may be risk factors for osteoporosis in patients with pemphigus, while outdoor activity may be a protective factor. The prevention and treatment of osteoporosis in pemphigus patients are still not standardized.

Key words: Pemphigus, Glucocorticoids, Osteoporosis, Bone density, Risk factors