title: Glucocorticoid excess affects cortical bone geometry in premenopausal, but not postmenopausal, women.
abstract: Glucocorticoid (GC) excess causes a great increase in fracture risk, but the effects of GC excess on cortical bone geometry are unknown. The present study was performed to examine the effects of GC excess on cortical bone geometry in both premenopausal and postmenopausal women. Ninety-six women receiving oral GC treatments and 10 women with Cushing syndrome (CS) were each compared to age-matched control subjects using peripheral quantitative computed tomography. Total area, periosteal circumference, and polar strength strain index (SSIp) were significantly lower in GC-treated patients compared with control subjects in premenopausal women but not in postmenopausal women. Moreover, cortical area and thickness as well as periosteal circumference and SSIp were significantly lower in patients with CS compared to controls in premenopausal women but not in postmenopausal women. Total area, cortical area, cortical thickness, periosteal circumference, as well as SSIp were significantly lower in GC-treated patients with vertebral fractures compared to those without vertebral fractures in premenopausal women but not in postmenopausal women. In conclusion, endogenous or exogenous GC excess affects bone geometry of forearms of premenopausal, but not postmenopausal, women. These effects of GC excess on bone geometry may provide a strength loss mechanism beneath increased vertebral fracture risk.
authors.affiliation: Division of Diabetes, Metabolism, and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. hiroshik@med.kobe-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaji
authors.forename: Mika
authors.initials: M
authors.lastname: Yamauchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chihara
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000284:Administration, Oral; D000328:Adult; D003480:Cushing Syndrome / Q000097:blood / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000097:blood / Q000150:complications / Q000175:diagnosis; D010521:Periosteum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000378:metabolism; D017698:Postmenopause; D011239:Prednisolone / Q000009:adverse effects*; D017697:Premenopause; D016103:Spinal Fractures / Q000097:blood / Q000175:diagnosis / Q000209:etiology; D013131:Spine / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D014457:Ulna / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone; D006854:Hydrocortisone