Glucocorticoids and development of osteoporosis in patients with cushing's syndrome: a review
DOI:
https://doi.org/10.17564/2316-3798.2012v1n1p41-52Keywords:
Cushing’s syndrome, Glucocorticoid, Bone tissue, Osteoporosis
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Abstract
Osteoporosis is one of the most frequent complications during the use of glucocorticoids in patients with Cushing's syndrome and it is associated to a high rate of disability due to fractures. It can occur in 30-50% of patients in chronic use of glucocorticoids, mainly in areas rich in trabecular bone. Osteoporosis induced by glucocorticoids is involved with various direct and indirect complex effects, both systemic and local, on bone and mineral metabolism, and the cellular mechanisms for bone loss are not yet clearly defined. It is known that the main mechanism is based on the action over osteoblasts, osteoclasts and osteocytes, basic multicellular unit in bone structure. The standard pharmacological treatment of osteoporosis induced by glucocorticoids involves the use of bisphosphonates and reinstatement of calcium, which should be started soon after the start of chronic glucocorticoid therapy, and the treatment of Cushing's syndrome involves the gradual suspension of the use of corticosteroids.
