Rehman Qaiser, Lane Nancy E
South Central Kansas Bone and Joint Center, Pratt, Kansas 67124, USA.
Med Pediatr Oncol. 2003 Sep;41(3):212-6. doi: 10.1002/mpo.10339.
Glucocorticoid therapy is the most common cause of secondary iatrogenic osteoporosis. The bone loss occurs predominantly due to a decrease in bone formation, although increased bone resorption also occurs. Glucocorticoids induce osteoblast apoptosis and increase osteoclast survival and activity. Most of these effects are mediated through the RANKL-OPG system but perturbations in gonadal hormone activity and calcium balance may also contribute significantly to bone loss. Future therapies in the treatment and prevention of glucocorticoid-induced osteoporosis may be targeted at restoring the hormonal and cytokine balance to nullify the apoptotic effect of glucocorticoids on bone forming cells.
糖皮质激素治疗是继发性医源性骨质疏松最常见的病因。尽管骨吸收增加也会发生，但骨质流失主要是由于骨形成减少所致。糖皮质激素可诱导成骨细胞凋亡，增加破骨细胞的存活和活性。这些作用大多是通过RANKL-OPG系统介导的，但性腺激素活性和钙平衡的紊乱也可能对骨质流失有显著影响。未来治疗和预防糖皮质激素性骨质疏松的疗法可能旨在恢复激素和细胞因子平衡，以消除糖皮质激素对骨形成细胞的凋亡作用。
