Yamauchi Mika
Internal Medicine 1, Shimane University Faculty of Medicine, Izumo, Japan.
Clin Calcium. 2018;28(12):1635-1640.
Glucocorticoid(GC)excess is one of the most common causes of secondary osteoporosis, which can be associated with a disease(GC excess due to Cushing's syndrome)or with a treatment(GC medications). In addition to Cushing's syndrome, subclinical Cushing's syndrome, which occurs more frequently, can also increase the risk of fractures. Thus, it is important to consider these diseases when making the diagnosis for osteoporosis. GC-induced osteoporosis leads to reduction of bone mineral density and increased risk of fracture from the early stage after initiation of GC treatment, and thus requires management from the time of initiation. The 2014 revised Guidelines on the Management and Treatment of GC-induced Osteoporosis should be used routinely in the clinical settings as they introduce a scoring system that is easily adoptable.
糖皮质激素（GC）过量是继发性骨质疏松最常见的病因之一，它可能与某种疾病（库欣综合征导致的GC过量）或某种治疗（GC药物治疗）有关。除库欣综合征外，更常见的亚临床库欣综合征也会增加骨折风险。因此，在诊断骨质疏松时考虑这些疾病很重要。GC诱导的骨质疏松从GC治疗开始的早期就会导致骨密度降低和骨折风险增加，因此从开始治疗时就需要进行管理。2014年修订的GC诱导骨质疏松管理与治疗指南应在临床环境中常规使用，因为它们引入了一种易于采用的评分系统。
