Glucocorticoid-induced bone fragility.
Glucocorticoid (GC) use results in rapid bone loss and an elevated risk of fracture. The excess bone fragility from GC treatment is multifactorial. GCs increase bone remodeling through reductions in gonadal hormones, elevations in PTH from negative calcium balance, early stimulation of osteoclast maturation and activity, and delayed, sustained reduction in osteogenesis and osteoblast activity. GCs also alter the metabolism of osteocytes so that increased osteocyte lacunae size, with demineralization around the osteocyte and reduced elastic modulus, is observed in a mouse model of GC-induced bone loss. In summary, GC effects on bone fragility are multifactorial, and additional studies are now under way to clarify how GCs alter osteocyte metabolism and result in reduction in localized bone strength.
Lane
Nancy E
NE
Department of Medicine, University of California, Sacramento, California, USA. nelane@ucdavis.edu
Yao
Wei
W
D000818:Animals; D015519:Bone Density / Q000187:drug effects; D016723:Bone Remodeling / Q000187:drug effects / Q000502:physiology; D050723:Fractures, Bone / Q000139:chemically induced*; D005938:Glucocorticoids / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D051379:Mice; D010012:Osteogenesis / Q000187:drug effects
D005938:Glucocorticoids
Arthritis Rheum. 2008 Jun;58(6):1674-86
18512788
J Musculoskelet Neuronal Interact. 2008 Oct-Dec;8(4):330-1
19147962
Arthritis Rheum. 2008 Nov;58(11):3485-97
18975341
Arthritis Rheum. 2003 Nov;48(11):3224-9
14613287
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18280232
J Bone Miner Res. 2009 May;24(5):768-74
19113932
J Bone Miner Res. 2006 Mar;21(3):466-76
16491295
Calcif Tissue Res. 1969 Aug 11;4(1):1-12
4310125