Glucocorticoid-induced osteoporosis: an update
Abstract
Glucocorticoid-induced osteoporosis occurs in two phases: a rapid, early phase in which bone mineral density is reduced, possibly as a result of excessive bone resorption, and a slower, progressive phase in which bone mineral density declines because of impaired bone formation. Although the indirect effects of glucocorticoids on bone are evident, their direct effects on osteoblasts, osteoclasts and osteocytes are primarily operative in the pathogenesis of glucocorticoid-induced osteoporosis. The management of patients exposed to glucocorticoids includes general health measures, sufficient calcium and vitamin D, and reducing the therapeutic regimen to the minimal effective dose. The gold standard in the pharmacological treatment of glucocorticoid-induced osteoporosis in postmenopausal women involves the use of bisphosphonates, which should be started soon after beginning chronic glucocorticoid therapy. Anabolic and alternative therapeutic strategies are currently under investigation in glucocorticoid-induced osteoporosis.
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Glucocorticoids indirectly decrease production of insulin-like growth factors and shift transforming growth factor-beta binding.
“Indirect actions of GCs involve decreased production of insulin-like growth factors (IGFs) and shifting transforming growth factor-β (TGF-β) binding [4, 5].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [5]
In functional GnRH deficiency, the pattern of GnRH secretion is altered, involving reduced frequency of pulsations and decreased pulse amplitude.
“In cases of functional GnRH deficiency the pattern of GnRH secretion is altered, involving reduced frequency of pulsations and decreased pulse amplitude [4, 5].”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [5]
Catabolic effects of glucocorticoids on muscle could contribute to fracture risk because muscle weakness increases the incidence of falls.
“The catabolic effects of GCs on muscle could contribute to the fracture risk because muscle weakness increases the incidence of falls.”
From Pituitary Disorders and Osteoporosis (2015) · cites this paper as [5]
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References 71 · Cited by 362
- Authors
- Mazziotti, G., Angeli, A., Bilezikian, J. P., Canalis, E., & Giustina, A.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- Ospedale San Luigi Gonzaga (IT)
- Columbia University (US)
- Saint Francis Hospital & Medical Center (US)
- Corresponding author
- Giustina, Andrea
- Venue
- Trends in Endocrinology & Metabolism
- Publisher
- Elsevier BV
- Published
- 2006-05
- Volume
- 17
- Issue
- 4
- Pages
- 144-149
- ISSN
- 1043-2760 (ISSN-L)
- OpenAlex
- W2161886804
- Cited by
- 362
- References
- 71
- Citations by year
- 2026: 4 · 2025: 10 · 2024: 13 · 2023: 8 · 2022: 14 · 2021: 15 · 2020: 16 · 2019: 8 · 2018: 20 · 2017: 11 · 2016: 16 · 2015: 14 · 2014: 22 · 2013: 21 · 2012: 26
- FWCI
- 5.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Trends in Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK045227, DK 45227)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Keywords
- glucocorticoid-induced osteoporosis, bone mineral density, bone resorption, bone formation, osteoblasts, osteoclasts, osteocytes, calcium and vitamin D supplementation, bisphosphonates, postmenopausal women, anabolic therapy, minimum effective dose
- MeSH terms
- Bone and Bones, Bone Resorption, Calcium, Cushing Syndrome, Diphosphonates, Female, Glucocorticoids, Humans, Osteoblasts, Osteoclasts, Osteocytes, Osteogenesis, Osteoporosis, Vitamin D, Bone Density, Osteoporosis, Postmenopausal, Fractures, Bone
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