Biomarkers of Bone Turnover after a Short Period of Steroid Therapy in Elderly Men

Abstract

An excess of glucocorticoids is the third most common cause of bone loss after postmenopausal and senile osteoporosis. The iatrogenic form of glucocorticoid-induced osteoporosis, which is more frequent than Cushing syndrome, has uncertain cellular and molecular bases. The lack of consistent information concerning the pathophysiology of corticosteroid-related bone loss is attributable to several coexisting factors, e.g., the heterogeneity of the underlying disease, that may themselves influence skeletal loss, dosage, and duration of treatment (1)(2). A well-known action of steroids on bone is decreased bone formation. There are no consistent findings concerning bone resorption in glucocorticoid-induced osteoporosis. The aim of this study was to evaluate the impact of a short period of steroid therapy on the serum concentrations of bone biomarkers in elderly men. We studied 14 elderly men (mean age ± SD, 66.1 ± 6.4 years; range, 57–76 years), admitted to our hospital from October 1998 to June 1999, who were suffering from various medical pathologies requiring systemic steroid therapy. Four patients were suffering from pulmonary diseases, four from immunologic, two from cerebral, and four from neoplastic diseases without bone metastases. None of these patients was bedridden. The patients were studied while undergoing treatment, which lasted no more than 30 days (mean ± SD, 9.1 ± 9.6 days), with a cumulative dose of 10–1250 mg of prednisone (mean prednisone equivalent, 338 ± 382 mg) or its equivalent. The patients were compared with 14 hospitalized patients of similar age (67.9 ± 6.7 years) without any history of …