Ultrastructural characteristics of glucocorticoid-induced osteoporosis

Excerpt

Glucocorticoid-induced osteoporosis (GIO) is the most common cause of secondary osteoporosis. Fractures may occur in as many as 30–50% of patients receiving chronic glucocorticoid (GC) therapy. They concern more frequently the sites enriched in cancellous bone such as vertebrae and femoral neck [1]. Bone loss depends on the GC ingested dose but without “security dose” and depends on the ingestion route [2]. The underlying disorder for which inhaled or systemic glucocorticoids (GCs) are used may also be a cause of bone loss. In human subjects, GIO occurs in two phases: a rapid early phase in which bone mineral density falls and can reach up to 5–15% per year, probably as a result of excessive bone resorption and a slower phase in which bone mineral density declines more slowly, about 2% per year, mostly because of impaired bone formation. There is probably a reversibility of fracture risk after discontinuation of corticosteroid treatment [1]. …