How do glucocorticoids cause osteonecrosis?
Glucocorticoids have direct adverse effects on osteoblasts, osteoclasts, and osteocytes. These drugs decrease lacunar– canalicular fluid, bone vascularity, and bone strength via their effects on osteocytes. Glucocorticoid-induced osteocyte apoptosis accumulates and can lead to osteonecrosis, even without osteoporosis.
Why are glucocorticoids contraindicated in osteoporosis?
The stimulation of bone resorption is likely responsible for the initial bone loss after glucocorticoid exposure. Eventually, the inhibition of bone formation will cause a decrease in bone remodeling and a continued increased risk of fractures.
Which of the following bones is affected more by glucocorticoid-induced osteoporosis?
BMD loss is an immediate consequence of the introduction of GCs and affects the trabecular bone (ie, spine) more than it does the cortical bone (ie, femur).
What are the effects of glucocorticoids on bone as it related to osteoporosis?
Glucocorticoid therapy is associated with an appreciable risk of bone loss, which is most pronounced in the first few months of use. In addition, glucocorticoids increase fracture risk, and fractures occur at higher bone mineral density (BMD) values than occur in postmenopausal osteoporosis.
How do corticosteroids cause osteoporosis?
Causes and Risk Factors Corticosteroids tend to both reduce the body’s ability to absorb calcium and increase how fast bone is broken down. The more of these drugs you take and the longer you take them, the greater your risk of developing osteoporosis.
How do glucocorticoids affect bone?
Glucocorticoids cause profound effects on bone cell replication, differentiation, and function. Glucocorticoids increase bone resorption by stimulating osteoclastogenesis by increasing the expression of RANK ligand and decreasing the expression of its decoy receptor, osteoprotegerin.
How do glucocorticoids affect bone mineralization?
Glucocorticoids may prolong the life of mature osteoclasts under selected conditions. Eventually, glucocorticoids decrease bone remodeling by depleting the population of osteoblasts. This occurs by a decrease in osteoblastogenesis, and an increase in the apoptosis of mature osteoblasts and osteocytes.
How does glucocorticoid affect bones?
Can steroid inhalers cause osteoporosis?
Taking steroid inhalers or tablets to treat asthma or control flare-ups is linked to a heightened risk of brittle bones (osteoporosis) and increased vulnerability to broken bones (fragility fractures), finds new research.
What is the pathophysiology of glucocorticoid-induced osteoporosis?
Glucocorticoid-induced osteoporosis is the most common secondary cause of osteoporosis and the resulting fractures cause significant morbidity. Following initiation of oral glucocorticoids, rapid bone loss occurs, and fracture risk increases within a few months in a dose-dependent manner.
What is the prevalence of glucocorticoid-induced osteonecrosis?
Glucocorticoid- induced osteonecrosis develops in 9–40% of patients receiving long-term therapy although it may also occur with short-term exposure to high doses, after intra-articular injection, and without glucocorticoid-induced osteoporosis.
What are the adverse effects of glucocorticoids on osteocytes?
Glucocorticoids have direct adverse effects on osteoblasts, osteoclasts, and osteocytes. These drugs decrease lacunar– canalicular fluid, bone vascularity, and bone strength via their effects on osteocytes. Glucocorticoid-induced osteocyte apoptosis accumulates and can lead to osteonecrosis, even without osteoporosis.
What is corticosteroid-induced osteoporosis?
Abstract Corticosteroid-induced osteoporosis is the most common form of secondary osteoporosis and the first cause in young people. Bone loss and increased rate of fractures occur early after the initiation of corticosteroid therapy, and are then related to dosage and treatment duration.