Journal
BONE
Volume 46, Issue 3, Pages 564-570Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bone.2009.06.030
Keywords
Glucocorticoid-induced osteoporosis; Fractures; Osteoblast and osteocyte apoptosis; Bone formation; 11 beta-hydroxysteroid dehydrogenase; Bone vasculature; Bone hydration; Angiogenesis; Bone density; Bone strength; Osteonecrosis
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Funding
- Office of Research and Development, Department of Veterans Affairs
- National Institutes of Health [P01-AG13918]
- UAMS College of Medicine
- NATIONAL INSTITUTE ON AGING [P01AG013918] Funding Source: NIH RePORTER
- Veterans Affairs [I01BX000436] Funding Source: NIH RePORTER
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Glucocorticoid administration is required for many inflammatory and autoimmune diseases, but use of these drugs is associated with skeletal side effects including bone loss, fractures, and osteonecrosis. Fractures often occur without a reduction in bone mineral density, strongly suggesting that glucocorticoid excess adversely affects other aspects of bone strength. Although the primary effects of glucocorticoid excess on the skeleton are directly on bone cells, a vascular connection between these cells and the loss of bone strength appears likely. This review examines this connection and how it may explain the greater decline in bone strength than loss of bone mass that occurs with glucocorticoid excess. Published by Elsevier Inc.
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