title: Glucocorticoid-induced osteoporosis: pathophysiological role of GH/IGF-I and PTH/VITAMIN D axes, treatment options and guidelines.
abstract: Glucocorticoid-induced osteoporosis is the most frequent form of secondary osteoporosis caused by chronic exposure to glucocorticoid excess. Pathogenesis of glucocorticoid-induced osteoporosis is multifactorial including direct effects of glucocorticoids on bone cells and indirect effects of glucocorticoids on several neuroendocrine and metabolic pathways. Fragility fractures occur early in glucocorticoid-induced osteoporosis and anti-osteoporotic drugs along with calcium and vitamin D should be started soon after exposure to glucocorticoid excess. This paper summarizes some of the main topics discussed during the 9th Glucocorticoid-Induced Osteoporosis Meeting (Rome, April 2016) with a specific focus on the role of growth hormone/insulin-like growth factor-1 and parathyroid hormone/vitamin D axes in the pathogenesis of glucocorticoid-induced osteoporosis and the controversial aspects concerning therapeutic approach to skeletal fragility in this clinical setting.
authors.affiliation: Chair of Endocrinology, University of Brescia, Brescia, Italy.
authors.forename: Gherardo
authors.initials: G
authors.lastname: Mazziotti
authors.affiliation: Chair of Endocrinology, University of Brescia, Brescia, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Formenti
authors.affiliation: McGuire Veterans Affairs Medical Center, Virginia Commonwealth University School of Medicine Richmond, Virginia, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Adler
authors.affiliation: Department of Medicine Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Bilezikian
authors.affiliation: Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, OX3 7LE, UK.
authors.forename: Ashley
authors.initials: A
authors.lastname: Grossman
authors.affiliation: Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, University of Oxford, Oxford, OX3 7LE, UK.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sbardella
authors.affiliation: Department of Internal Medicine and Medical Disciplines "Sapienza" Rome University, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Minisola
authors.affiliation: Chair of Endocrinology, University of Brescia, Brescia, Italy. a.giustina@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Giustina
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects*; D013006:Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D010024:Osteoporosis / Q000139:chemically induced* / Q000188:drug therapy / Q000378:metabolism; D010281:Parathyroid Hormone / Q000378:metabolism; D014807:Vitamin D / Q000378:metabolism
chemical_list: D050071:Bone Density Conservation Agents; D005938:Glucocorticoids; C583557:IGF1 protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone
keywords: Glucocorticoids; Growth hormone; Guidelines; Osteoporosis; PTH; Vitamin D