Glucocorticoid induced risk of fractures

In recent years studies have emphasized the importance of glucocorticoid-induced osteoporosis as the second most common form of osteoporosis after postmenopausal osteoporosis. Several studies have underlined that glucocorticoids are responsible for decreasing bone mineral density and increasing bone fragility, resulting in a large increase in fracture risk. This review wants to provide a background regarding the fracture risk of patients exposed to glucocorticoid treatment, considering the fracture risk as the most appropriate parameter to valuate glucocorticoid-induced osteoporosis. In fact, glucocorticoid treatment induces bone loss and increases fracture risk above all affecting trabecular bone, probably through an alteration in bone turnover and microarchitectural changes responsible for an early increased fracture risk which is primary influenced by dose and duration of treatment, body mass index, age and female gender.