Reumatizam, Vol. 61 No. 2, 2014.
Pregledni rad
Glucocorticoid induced osteoporosis
Branimir Anić
; Zavod za kliničku imunologiju i reumatologiju, Klinika za unutarnje bolesti Medicinskoga fakulteta Sveučilišta u Zagrebu, Klinički bolnički centar Zagreb, Zagreb, Hrvatska
Miroslav Mayer
; Zavod za kliničku imunologiju i reumatologiju, Klinika za unutarnje bolesti Medicinskoga fakulteta Sveučilišta u Zagrebu, Klinički bolnički centar Zagreb, Zagreb, Hrvatska
Sažetak
Secondary osteoporosis most often develops due to glucocorticoid therapy. Glucocorticoids affect all stages of the bone remodeling cycle, its formation and resorption. Osteoblasts are primarily affected, decreasing their activity and enhancing apoptosis. Patients treated with glucocorticoids have lower bone mineral density and increased fracture risk. Glucocorticoid-induced osteoporosis can be prevented by administering the minimal effective dose of glucocorticoids, calcium and vitamin D supplementation or, if possible, by hormone replacement therapy. Moreover, appropriate physical activity should be encouraged. Patients who are at higher risk for low-energy fractures (for example post-menopausal women) have to be actively treated, usually with antiresorptive drugs among which bisphosphonates are currently the first line therapy.
Ključne riječi
osteoporosis; glucocorticoids; diagnostics; prevention; treatment
Hrčak ID:
137907
URI
Datum izdavanja:
23.10.2014.
Posjeta: 1.633 *