Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.

Glucocorticoid-induced osteoporosis (GIO) is the most frequent form of secondary bone disorders. Most of our knowledge on its pathogenesis and treatment has been obtained by investigating patients treated with exogenous glucocorticoids. This review will focus on the bone disorder in endogenous Cushi...

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Main Authors: Tóth, M, Grossman, A
Format: Journal article
Language:English
Published: 2013
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author Tóth, M
Grossman, A
author_facet Tóth, M
Grossman, A
author_sort Tóth, M
collection OXFORD
description Glucocorticoid-induced osteoporosis (GIO) is the most frequent form of secondary bone disorders. Most of our knowledge on its pathogenesis and treatment has been obtained by investigating patients treated with exogenous glucocorticoids. This review will focus on the bone disorder in endogenous Cushing's syndrome, updating recent advances in its pathophysiology, diagnostic aspects and the various predictors which are important in determining bone mineral density (BMD) and fracture risk. We now know strong evidence that beside BMD, bone microarchitecture, one of the most important elements of bone quality, is a key factor in determining fracture risk. Recently, two new methods (spinal deformity index and trabecular bone score) have been shown to be useful markers of bone microarchitecture in GIO. Investigations of GIO in endogenous Cushing's syndrome have also contributed to our understanding on its natural history and reversibility. Relying on recently published guidelines for management of exogenous GIO, a short list of suggestions is provided regarding the optimal diagnostic and therapeutic approach to patients with endogenous GIO.
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spelling oxford-uuid:cb85bd96-f049-4a22-8b83-aba405ab39992022-03-27T07:15:27ZGlucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:cb85bd96-f049-4a22-8b83-aba405ab3999EnglishSymplectic Elements at Oxford2013Tóth, MGrossman, AGlucocorticoid-induced osteoporosis (GIO) is the most frequent form of secondary bone disorders. Most of our knowledge on its pathogenesis and treatment has been obtained by investigating patients treated with exogenous glucocorticoids. This review will focus on the bone disorder in endogenous Cushing's syndrome, updating recent advances in its pathophysiology, diagnostic aspects and the various predictors which are important in determining bone mineral density (BMD) and fracture risk. We now know strong evidence that beside BMD, bone microarchitecture, one of the most important elements of bone quality, is a key factor in determining fracture risk. Recently, two new methods (spinal deformity index and trabecular bone score) have been shown to be useful markers of bone microarchitecture in GIO. Investigations of GIO in endogenous Cushing's syndrome have also contributed to our understanding on its natural history and reversibility. Relying on recently published guidelines for management of exogenous GIO, a short list of suggestions is provided regarding the optimal diagnostic and therapeutic approach to patients with endogenous GIO.
spellingShingle Tóth, M
Grossman, A
Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.
title Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.
title_full Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.
title_fullStr Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.
title_full_unstemmed Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.
title_short Glucocorticoid-induced osteoporosis: lessons from Cushing's syndrome.
title_sort glucocorticoid induced osteoporosis lessons from cushing s syndrome
work_keys_str_mv AT tothm glucocorticoidinducedosteoporosislessonsfromcushingssyndrome
AT grossmana glucocorticoidinducedosteoporosislessonsfromcushingssyndrome