Glucocorticoid-induced osteoporosis: Mechanisms of bone loss

스테로이드 호르몬의 뼈에 대한 영향은 초기에는 bone resorption을 증가시키며(PTH에 의한 bone formation 증가도 있지만 다소 약한 정도), 지속 사용하면 bone resorption은 느려지고 bone formation 억제가 두드러집니다.

The deleterious effects of glucocorticoid excess on bone result from direct effects on osteoblasts, osteocytes, and osteoclasts. Glucocorticoids increase bone resorption and reduce bone formation. The risk of bone loss is most pronounced in the first few months of use, followed by slower but steady loss of bone with continued use. Most agents that increase bone loss, such as thyroxine or sustained elevation of parathyroid hormone (PTH), accelerate not only bone resorption but also formation, albeit to a lesser extent. Because glucocorticoids accelerate resorption while inhibiting formation, their use is associated with early rapid bone loss. With chronic use, osteoclast-mediated bone resorption slows, and suppression of bone formation becomes the predominant skeletal effect.

REF. UpToDate 2017.12.30