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Osteoporosis associated with excess glucocorticoids.

Joseph L Shaker1, Barbara P Lukert

  • 1Endocrine-Diabetes Center, St. Luke's Medical Center, University of Wisconsin School of Medicine, 2801 West KK River Parkway, Suite 245, Milwaukee, WI 53215, USA. joseph.shaker@aurora.org

Endocrinology and Metabolism Clinics of North America
|April 27, 2005
PubMed
Summary

Excess glucocorticoids can lead to osteoporosis and fractures. Early evaluation, bone density measurement, and treatment with calcium, vitamin D, and antiresorptive therapy are recommended for patients on glucocorticoids.

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Area of Science:

  • Endocrinology
  • Bone Metabolism
  • Pharmacology

Background:

  • Glucocorticoids, both endogenous and exogenous, are linked to osteoporosis and fractures.
  • Even low-dose oral glucocorticoids and mild hypercortisolism can cause bone loss.
  • Patients on glucocorticoid therapy often lack appropriate evaluation and treatment for bone loss.

Purpose of the Study:

  • To highlight the risk of bone loss associated with glucocorticoid use.
  • To emphasize the need for proactive bone health management in patients on glucocorticoids.
  • To recommend diagnostic and therapeutic strategies for glucocorticoid-induced bone disease.

Main Methods:

  • Review of existing literature on glucocorticoid effects on bone.
  • Analysis of clinical implications for patients on chronic or initiating glucocorticoid therapy.

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  • Synthesis of recommendations for bone density assessment and laboratory studies.

    • Main Results:

    • Glucocorticoid excess is a significant risk factor for osteoporosis and fractures.
    • Bone loss can occur even with low-dose glucocorticoids or mild hypercortisolism.
    • Current clinical practice often overlooks the bone health of patients on glucocorticoids.

    Conclusions:

    • Patients on chronic glucocorticoids or initiating therapy require bone density measurement and laboratory evaluation.
    • Adequate calcium and vitamin D intake is crucial.
    • Antiresorptive therapy, especially bisphosphonates, should be considered for managing glucocorticoid-induced bone loss.