| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Medicina Interna I (A.D., L.P., G.O., M.V., A.T., A.A.) and Centro Riferimento Regionale Sclerosi Multipla Neurobiologia Clinica (E.M., A.B.), Dipartimento di Scienze Cliniche e Biologiche, University of Turin, 10043 Orbassano (TO), Italy
Address all correspondence and requests for reprints to: A. Dovio, Medicina Interna I, Dipartimento di Scienze Cliniche e Biologiche, University of Turin, A.S.O. San Luigi, Regione Gonzole 10, 10043 Orbassano (TO), Italy. E-mail: dovioaa{at}libero.it.
Glucocorticoid (GC)-induced osteoporosis is the leading form of secondary osteoporosis. Bone loss can be rapid. However, longitudinal studies at the very beginning of treatment are scarce. Patients relapsing from multiple sclerosis are treated with high-dose, short-term iv GCs. A number of them are young, without concomitant disease affecting bone and with no substantial impairment of mobility. Such patients were selected for the present study. Thirteen patients suffering from multiple sclerosis [11 females, two males; age 32 ± 2 yr (mean ± SE)] and receiving iv methylprednisolone 15 mg/kg daily for 10 d completed the study. We measured serum osteocalcin (OC), aminoterminal propeptide of type I collagen (PINP), bone isoform of alkaline phosphatase (bALP), carboxyterminal telopeptide of type I collagen (CTX), and urinary calcium/creatinine ratio (uCa/Cr) during the 10-d cycle and 3 months later. Dual-energy x-ray absorptiometry and calcaneal quantitative ultrasonometry were performed before and 6 months after therapy. We found an immediate, impressive fall of OC and PINP (–80 ± 3 and –54 ± 5% at d 2, respectively), which persisted throughout the whole treatment period (P < 0.0001 for both markers). bALP levels showed only a modest decrease at d 6 (–19 ± 7%, P < 0.05), with subsequent return to baseline in d 7–10. After 3 months, OC, PINP, and bALP levels rose to +51 ± 22, +37 ± 16 (not significant), and +61 ± 17% (P < 0.01) with respect to baseline, respectively. uCa/Cr and CTX showed a progressive, marked increase during treatment, peaking at d 7–9 (+92 ± 44 and +149 ± 63%, respectively), with subsequent decrement at d 10 (P < 0.01 and P < 0.05, respectively) despite continuing GC administration. After 3 months, uCa/Cr and CTX levels were also higher than baseline. No change in quantitative ultrasonometry parameters and bone mineral density was observed 6 months after therapy. In conclusion, high-dose, short-term iv GC regimens cause an immediate and persistent decrease in bone formation and a rapid and transient increase of bone resorption. Our data also support the concept that discontinuation of such regimens is followed by a high bone turnover phase.
This article has been cited by other articles:
 |
|
 |
|
  H. Zhou, W. Mak, Y. Zheng, C. R. Dunstan, and M. J. Seibel Osteoblasts Directly Control Lineage Commitment of Mesenchymal Progenitor Cells through Wnt Signaling J. Biol. Chem., January 25, 2008; 283(4): 1936 - 1945. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Teitelbaum Osteoclasts: What Do They Do and How Do They Do It? Am. J. Pathol., February 1, 2007; 170(2): 427 - 435. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Dovio, L. Perazzolo, L. Saba, A. Termine, M. Capobianco, A. Bertolotto, and A. Angeli High-dose glucocorticoids increase serum levels of soluble IL-6 receptor {alpha} and its ratio to soluble gp130: an additional mechanism for early increased bone resorption. Eur. J. Endocrinol., May 1, 2006; 154(5): 745 - 751. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
