Abstract
Glucocorticoids 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. Insulin resistance is the key pathology in type 2 diabetes negatively influence bone remodeling and leads to reduced bone strength. Loss of sex steroids, particularly oestradiol, as in ovariectomized rats,leads to increased skeletal remodeling over and above the age-related increment, together with excessive osteoclast activity. In this study, ovariectomy DEX group has highly significant increase in relative cortical resorptioncompared to ovaiectomy and sham DEX groups, also ovariectomy and DEX group has highly significant decrease in bone thickness compared to ovariectomy and sham DEX groups. The consequent increase in remodeling activation increases the overall resorption rate without a compensatory increase in formation, leading to rapid bone loss.This negative effect on bone which is due to the glucocorticoid excess is also mediated by indirect mechanisms such as the calcium malabsorption and hypercalciuria. In response to the enhanced supply of calcium from the skeleton, PTH secretion tends to be diminished, thereby reducing vitamin D [1,25(OH)2 cholecalciferol] concentration with a consequent reduction in calcium absorption.
Highlights
IntroductionAs seen in Cushing’s syndrome or with clinical administration of glucocorticoids that is used to treat acute and chronic inflammatory diseases, leads to symptoms of abdominal obesity, hypertension, glucose intolerance or diabetes and dyslipidemia, all of which are features of insulin resistance [1,2].Insulin resistance increases the risk of developing type 2 diabetes.The pathophysiology of type 2 diabetes mellitus (T2DM) may negatively influence bone formation [3,4,5,6].Glucocorticoids modify osteoblastic cells through inhibiting osteoblast maturation and reduce their synthetic capacity, thereby reducing the amount of bone formed during each remodeling cycle [7]Osteoporosis is a skeletal disease characterized by low bone mass and the structural deterioration of bone resulting in, increase susceptibility to fractures [8] .Imbalance between bone formation and bone resorption is the predominant mechanism behind osteoporosis [9]
Osteoporosis is a skeletal disease characterized by low bone mass and the structural deterioration of bone resulting in, increase susceptibility to fractures [8] .Imbalance between bone formation and bone resorption is the predominant mechanism behind osteoporosis [9]
Parallel to the long axis of the bones extending from one-third to one-half the thickness of the Dexamethasone injection in sham operated group induced significant increase in blood glucose and insulin levels compared to sham control group
Summary
As seen in Cushing’s syndrome or with clinical administration of glucocorticoids that is used to treat acute and chronic inflammatory diseases, leads to symptoms of abdominal obesity, hypertension, glucose intolerance or diabetes and dyslipidemia, all of which are features of insulin resistance [1,2].Insulin resistance increases the risk of developing type 2 diabetes.The pathophysiology of type 2 diabetes mellitus (T2DM) may negatively influence bone formation [3,4,5,6].Glucocorticoids modify osteoblastic cells through inhibiting osteoblast maturation and reduce their synthetic capacity, thereby reducing the amount of bone formed during each remodeling cycle [7]Osteoporosis is a skeletal disease characterized by low bone mass and the structural deterioration of bone resulting in, increase susceptibility to fractures [8] .Imbalance between bone formation and bone resorption is the predominant mechanism behind osteoporosis [9]. As seen in Cushing’s syndrome or with clinical administration of glucocorticoids that is used to treat acute and chronic inflammatory diseases, leads to symptoms of abdominal obesity, hypertension, glucose intolerance or diabetes and dyslipidemia, all of which are features of insulin resistance [1,2]. Insulin resistance increases the risk of developing type 2 diabetes.The pathophysiology of type 2 diabetes mellitus (T2DM) may negatively influence bone formation [3,4,5,6]. Osteoporosis is a skeletal disease characterized by low bone mass and the structural deterioration of bone resulting in, increase susceptibility to fractures [8] .Imbalance between bone formation and bone resorption is the predominant mechanism behind osteoporosis [9]
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