[Biochemical markers of bone turnover. New aspect. Biochemical bone markers of bone in patients treated with glucocorticoid].

Bone mineral density (BMD) is not sensitive enough to assess the bone strength especially in patients treated with glucocorticoid (GC) . GC therapy induces deterioration of bone quality. The measurements of biochemical bone markers which can be measured in medical practice in Japan are the useful tool for assessing the bone quality. Our study revealed that urinary deoxypyridinoline level was a BMD-independent marker for prevalent vertebral fractures in GC-treated postmenopausal women. Administration of high dose of GC causes an immediate decrease in bone formation followed by a rapid and transient increase in bone resorption. In patients receiving high dose of GC, there were uncoupling between bone formation and bone resorption which causes bone loss as well as bone fragility. In patients with GC treatment, bisphosphonate is effective in decreasing bone resorption marker. The suppression of bone resorption by bisphosphonate inhibits bone loss and deterioration of bone strength in GIO.