Shaker Joseph L, Lukert Barbara P
Endocrine-Diabetes Center, St. Luke's Medical Center, University of Wisconsin School of Medicine, 2801 West KK River Parkway, Suite 245, Milwaukee, WI 53215, USA.
Endocrinol Metab Clin North Am. 2005 Jun;34(2):341-56, viii-ix. doi: 10.1016/j.ecl.2005.01.014.
Excess glucocorticoids, whether endogenous or exogenous, can cause osteoporosis and fractures. Even low doses of oral glucocorticoids and mild endogenous hypercortisolism may be associated with bone loss. Patients treated with glucocorticoids, however, often are not evaluated and treated for this problem. Patients on chronic glucocorticoids or initiating these drugs should have their bone density measured and appropriate laboratory studies. They should be treated with adequate calcium and vitamin D, and antiresorptive therapy (particularly bisphosphonates) should be considered.
无论是内源性还是外源性的糖皮质激素过量，均可导致骨质疏松和骨折。即使是低剂量的口服糖皮质激素和轻度内源性皮质醇增多症也可能与骨质流失有关。然而，接受糖皮质激素治疗的患者往往未针对这一问题进行评估和治疗。使用慢性糖皮质激素治疗或刚开始使用这些药物的患者，应检测其骨密度并进行适当的实验室检查。他们应接受充足的钙和维生素D治疗，并且应考虑采用抗吸收治疗（尤其是双膦酸盐类药物）。
