Glucocorticoid-induced osteoporosis: from basic mechanisms to clinical aspects.
Glucocorticoid (GC)-induced osteoporosis (GCOP) is the most common cause of osteoporosis in adults aged 20-45 years as well as the most common cause of iatrogenic osteoporosis. GC excess, either endogenous or exogenous, induces bone loss in 30-50% of cases. Indeed, bone loss leading to fractures is perhaps the most incapacitating, sometimes partially irreversible, complication of GC therapy. Nevertheless, GCOP is often underdiagnosed and left untreated. The following article provides an update on the cellular and molecular mechanisms implicated in the pathophysiology of GC-induced bone loss, as well as some guidelines on diagnostic, preventive and therapeutic strategies for this medical condition, in an effort to promote a better knowledge and greater awareness of GCOP by both the patient and the physician.
Alesci
Salvatore
S
Clinical Neuroendocrinology Branch, National Institute of Mental Health, Bethesda, MD 20892-1284, USA. alescisa@mail.nih.gov
De Martino
Massimo U
MU
Ilias
Ioannis
I
Gold
Philip W
PW
Chrousos
George P
GP
D000818:Animals; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D005938:Glucocorticoids / Q000009:adverse effects* / Q000378:metabolism; D006133:Growth Substances / Q000378:metabolism; D006801:Humans; D010006:Osteoblasts / Q000187:drug effects / Q000378:metabolism; D010010:Osteoclasts / Q000187:drug effects / Q000378:metabolism; D010012:Osteogenesis / Q000187:drug effects / Q000502:physiology; D010024:Osteoporosis / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy
D005938:Glucocorticoids; D006133:Growth Substances