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Glucocorticoid-related bone changes from endogenous or exogenous glucocorticoids
Amy H Warriner1, Kenneth G Saag
1aDivision of Endocrinology, Metabolism and Diabetes bDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Current Opinion in Endocrinology, Diabetes, and Obesity
|January 29, 2014
Summary
Glucocorticoids negatively affect bone health, causing osteoporosis. While exogenous steroid effects are understood, endogenous glucocorticoid impacts and optimal osteoporosis treatments require further research for better patient outcomes.
Area of Science:
- Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Glucocorticoids exert detrimental effects on bone density and integrity.
- Both exogenous steroid administration and endogenous glucocorticoid imbalances can lead to significant bone loss.
Purpose of the Study:
- To review current findings on glucocorticoid-induced osteoporosis.
- To examine bone changes in patients with endogenous glucocorticoid disorders.
- To assess current and future treatment strategies for steroid-induced bone disease.
Main Methods:
- Literature review of recent findings on glucocorticoid effects on bone.
- Analysis of outcomes in patients with exogenous steroid exposure.
- Examination of bone changes in endogenous glucocorticoid excess and deficiency.
Main Results:
- Endogenous glucocorticoid overproduction similarly harms bone, with effects reversible upon disease cure.
- Adrenal insufficiency and glucocorticoid replacement therapy also cause bone alterations.
- Current treatments effectively manage exogenous glucocorticoid-induced osteoporosis, but long-term bisphosphonate use warrants further investigation.
Conclusions:
- Glucocorticoid-induced osteoporosis is a complex condition increasingly understood through studies of both exogenous and endogenous exposures.
- Further research is needed to identify optimal osteoporosis treatments for patients with endogenous glucocorticoid derangements.
- Advancements in prevention and treatment for glucocorticoid-induced osteoporosis are anticipated.
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