What causes glucocorticoid-induced osteoporosis?
Glucocorticoid medications have both direct and indirect effects on bone tissue that leads to bone loss. These medications have a direct negative effect on bone cells, resulting in a reduced rate of bone formation. In addition, they can interfere with the body’s handling of calcium and affect levels of sex hormones, leading to increased bone loss. Anyone who is taking glucocorticoid medications and has other risk factors for osteoporosis is at especially high risk for developing glucocorticoid-induced osteoporosis and suffering a fracture. Major risk factors for osteoporosis are: • Older age (starting in the mid-30s but accelerating with advancing age) • Non-Hispanic white and Asian ethnic background • Small bone structure • Family history of osteoporosis or osteoporosis-related fracture in a parent or sibling • Previous fracture following a low-level trauma, especially after age 50 • Sex hormone deficiency, particularly estrogen deficiency, both in women (e.g., menopause) and men. • A
