Effects of glucocorticoids on growth and bone mineralization
Effects of glucocorticoids on growth and bone mineralization
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DOI：
10.1590/s0021-75572011000100002
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发表时间：
2011-02-01
影响因子：
3.3
通讯作者：
Pereira, Rosa Maria Rodrigues
中科院分区：
文献类型：
--
作者：
Donatti, Teresinha Lermen;Koch, Vera Hermina Kalika;Pereira, Rosa Maria Rodrigues
目的：回顾糖皮质激素作用的各种机制以及这些药物诱导骨质疏松和生长缺陷的能力。来源：在 MEDLINE 搜索的基础上，使用关键词和描述符“糖皮质激素”、“骨矿化”、“生长”和“副作用”对科学文献进行回顾，且仅限于过去十年发表的文章。这些文章引用的参考文献用于识别相关的较早出版物，重点是对理解该主题至关重要的里程碑式研究。研究结果摘要：重点放在糖皮质激素对调节线性生长的激素和细胞因子的作用上。糖皮质激素对骨骼系统的最终影响是对骨代谢的全身影响和对骨细胞的直接作用的结果，这会改变骨细胞计数并导致骨质流失。讨论了停止糖皮质激素治疗后追赶性生长和骨量恢复的机制，随后回顾了可用于评估骨代谢和矿化的诊断方法，以及预防和管理糖皮质激素引起的骨变化的措施。结论：逐案监测患者在检测并可能逆转与长期糖皮质激素治疗相关的损害方面发挥着重要作用。
Objective: To review the various mechanisms of glucocorticoid action and the ability of these agents to induce osteoporosis and growth deficits.Sources: A review of the scientific literature was conducted on the basis of a MEDLINE search using the keywords and descriptors "glucocorticoids," "bone mineralization," "growth," and "side effects" and limited to articles published in the last decade. The references cited by these articles were used to identify relevant older publications, with an emphasis on landmark studies essential to an understanding of the topic.Summary of the findings: Emphasis was placed on the actions of glucocorticoids on the hormones and cytokines that modulate linear growth. The end effects of glucocorticoids on the skeletal system are the result of systemic effects on bone metabolism and of direct actions on bone cells, which alter bone cell counts and predispose to bone loss. The mechanisms underlying catch-up growth and bone mass recovery after discontinuation of glucocorticoid treatment are discussed, followed by a review of diagnostic methods available for assessment of bone metabolism and mineralization and of measures for prevention and management of glucocorticoid-induced bone changes.Conclusion: Patient monitoring on a case-by-case basis plays an essential role in detection and, potentially, reversal of the damage associated with chronic glucocorticoid therapy.