title: Glucocorticoid-induced osteoporosis: an osteoblastic disease.
abstract: It is well-known that glucocorticoid-induced osteoporosis (GIO) is the most common form of secondary osteoporosis. It is estimated that 30% to 50% of patients receiving chronic glucocorticoid therapy suffer vertebral or hip fractures, which are often asymptomatic. Vertebral fractures occur early after exposure to glucocorticoids, at a time when bone mineral density (BMD) declines rapidly. Glucocorticoids impair osteoblast homeostasis and induce apoptosis of both osteoblasts and osteocytes, leading to suppression of bone formation. Glucocorticoids also favor osteoclastogenesis and, as a consequence, increase bone resorption. The end-point of these alterations is a net decrease in BMD and alterations in bone quality. Bisphosphonates have been approved for both prevention and treatment of GIO. At the present time, anabolic therapeutic agents are still under investigation.
authors.affiliation: Dipartimento di Fisiopatologia Medica, Policlinico Umberto I, Università degli Studi di Roma La Sapienza, 00166 Roma, Italy. silvia.migliaccio@uniroma1.it
authors.forename: Silvia
authors.initials: S
authors.lastname: Migliaccio
authors.forename: Marina
authors.initials: M
authors.lastname: Brama
authors.forename: Rachele
authors.initials: R
authors.lastname: Fornari
authors.forename: Emanuela A
authors.initials: EA
authors.lastname: Greco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Spera
authors.forename: Nazzarena
authors.initials: N
authors.lastname: Malavolta
mesh_terms: D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D010006:Osteoblasts / Q000473:pathology*; D010024:Osteoporosis / Q000139:chemically induced* / Q000473:pathology*
chemical_list: D005938:Glucocorticoids