Glucocorticoid-induced osteoporosis: mechanisms for bone loss; evaluation of strategies for prevention.

Published

Journal Article (Review)

Osteoporosis is a common complication of chronic glucocorticoid therapy, especially in older patients who already are at risk of having a reduced bone mass. Glucocorticoids cause bone loss by altering the bone remodeling sequence: bone resorption by osteoclasts is increased, and bone formation by osteoblasts is decreased. Serum levels of osteocalcin, a protein made by osteoblasts, are decreased with glucocorticoid therapy, further evidence of decreased osteoblast function. Glucocorticoids decrease calcium absorption by the gastrointestinal tract and increase renal calcium excretion. Several recent studies suggest that low-dose glucocorticoid therapy is not associated with bone loss. Calcium supplementation with vitamin D is recommended. Several short-term studies have shown prevention of glucocorticoid-induced bone loss with bisphosphonates, calcitonin, and progesterone. Long-term clinical trials should be undertaken to determine strategies to prevent this type of osteoporosis.

Full Text

Duke Authors

Cited Authors

  • Mitchell, DR; Lyles, KW

Published Date

  • September 1990

Published In

Volume / Issue

  • 45 / 5

Start / End Page

  • M153 - M158

PubMed ID

  • 2203846

Pubmed Central ID

  • 2203846

International Standard Serial Number (ISSN)

  • 0022-1422

Digital Object Identifier (DOI)

  • 10.1093/geronj/45.5.m153

Language

  • eng

Conference Location

  • United States