title: Effects of glucocorticoids on growth and bone mineralization.
abstract: OBJECTIVE
  To review the various mechanisms of glucocorticoid action and the ability of these agents to induce osteoporosis and growth deficits.
  
  
  METHODS
  A review of the scientific literature was conducted on the basis of a MEDLINE search using the keywords and descriptors "glucocorticoids," "bone mineralization," "growth," and "side effects" and limited to articles published in the last decade. The references cited by these articles were used to identify relevant older publications, with an emphasis on landmark studies essential to an understanding of the topic.
  
  
  RESULTS
  Emphasis was placed on the actions of glucocorticoids on the hormones and cytokines that modulate linear growth. The end effects of glucocorticoids on the skeletal system are the result of systemic effects on bone metabolism and of direct actions on bone cells, which alter bone cell counts and predispose to bone loss. The mechanisms underlying catch-up growth and bone mass recovery after discontinuation of glucocorticoid treatment are discussed, followed by a review of diagnostic methods available for assessment of bone metabolism and mineralization and of measures for prevention and management of glucocorticoid-induced bone changes.
  
  
  CONCLUSIONS
  Patient monitoring on a case-by-case basis plays an essential role in detection and, potentially, reversal of the damage associated with chronic glucocorticoid therapy.
authors.affiliation: Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Teresinha Lermen
authors.initials: TL
authors.lastname: Donatti
authors.forename: Vera Hermina Kalika
authors.initials: VH
authors.lastname: Koch
authors.forename: Liliam
authors.initials: L
authors.lastname: Takayama
authors.forename: Rosa Maria Rodrigues
authors.initials: RM
authors.lastname: Pereira
mesh_terms: D000293:Adolescent; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects*; D005260:Female; D050723:Fractures, Bone / Q000139:chemically induced / Q000378:metabolism; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000378:metabolism; D012307:Risk Factors
chemical_list: D005938:Glucocorticoids