库辛综合征的肌肉骨并发症 库辛综合征的肌肉骨并发症
Dorota Leszczyńska1, Alicja Szatko1, Lucyna Papierska1
1Department of Endocrinology, Centre of Postgraduate Medical Education, Bielanski Hospital, Warsaw, Poland.
Reumatologia
|September 25, 2023
概括
过多的葡萄糖皮质类固醇 (GCs) 会导致骨质损失和肌肉缩. 本综述涵盖GC诱导的骨质疏松症和肌肉病,包括预防和管理策略.
科学领域:
- 内分泌学 在内分泌学.
- 骨生物学 骨生物学 骨生物学
- 肌肉生理学 肌肉生理学
背景情况:
- 葡萄糖皮质类固醇 (GCs) 被广泛处方,导致长期暴露的显著副作用.
- 过多的GC会导致诸如心血管,代谢,精神病和肌肉骨疾病等并发症,包括骨质疏松症,骨质疏松症和肌肉病变.
- 尽管骨矿物质密度正常,但GC过量会导致骨折,影响骨形成和荷尔蒙轴.
研究的目的:
- 审查葡萄糖皮质类固醇诱导的骨质疏松症和肌肉病变的病理生理学,临床表现,预防和治疗.
- 阐明GC诱导的骨损失背后的直接和间接机制.
- 解释GC诱导的肌肉缩的分子机制.
主要方法:
- 对过度使用葡萄糖皮质类固醇的研究进行文献综述.
- 分析GC诱导的骨和肌肉疾病的病理生理学.
- 讨论临床表现,预防和管理策略.
主要成果:
- 过多的GC直接通过Wnt/β-catenin信号传递损害骨形成,间接通过激素轴抑制和维生素D对抗作用.
- 葡萄糖皮质类固醇诱导的神经病变涉及增加的蛋白质代谢和受损的合成,由ubiquitin-proteasome和lysosome途径介导.
- 骨折可以发生在GC过量甚至与正常的骨矿物质密度.
结论:
- 过多的葡萄糖皮质类固醇对骨健康和肌肉功能构成重大风险.
- 了解GC诱导的骨质疏松症和肌肉病的机制对于有效的预防和管理至关重要.
- 治疗策略包括补充和维生素D以及双酸盐.
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