Osteoporosis in Glucocorticoid-Dependent Asthmatic Patients

Abstract

Rib or vertebral fractures have been reported in 4.5 to 70% of glucocorticoid-treated patients with asthma, depending on the source of the data. Older age and postmenopausal status increase the risk of glucocorticoid-induced osteoporosis. The major pathogenetic mechanism appears to be direct glucocorticoid suppression of osteoblastic activity and bone formation. Other factors probably involved in the pathogenesis of glucocorticoid-induced osteoporosis include: (a) glucocorticoid inhibition of gastrointestinal absorption and urinary tubular reabsorption of calcium; (b) secondary hyperparathyroidism; and (c) sex hormone deficiency.