Management of glucocorticoid‐induced osteoporosis: What is new?

Compston, Juliet

doi:10.1111/1756-185x.13680

Cited by 4 publications

(4 citation statements)

References 38 publications

(61 reference statements)

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“…Glucocorticoid and diabetes induced osteoporosis share pathophysiological characteristics: a predominant decrease in bone formation rather than an increase in bone resorption and an increase in bone marrow adiposity [60][61][62]. In glucocorticoid-induced osteoporosis, after an early transient increase in bone resorption, there is a long-term suppression of bone formation related to an increased sclerostin secretion and up-regulation of peroxisome proliferator-activated receptor that favor the differentiation of pluripotent precursor cells to adipocytes rather than osteoblasts, contributing to bone marrow adipocyte expansion [63,64]. Fragility fractures are now recognized as an important complication of both diabetes mellitus type 1 and type 2, particularly in those with long-term disease, poor glycaemic control, β cells failure and insulin treatment [65].…”

Section: Oxytocin As a Therapeutic Agent: Perspectivesmentioning

confidence: 99%

Oxytocin and Bone: Review and Perspectives

Breuil

Trojani

Amri

2021

IJMS

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Recent data demonstrate the anabolic effect of oxytocin on bone. Bone cells express oxytocin receptors. Oxytocin promotes osteoblasts differentiation and function, leading to an increased bone formation with no effect on bone resorption and an improvement of bone microarchitecture. Oxytocin is synthetized by osteoblasts, and this synthesis is stimulated by estrogen. Animal studies demonstrate a direct action of oxytocin on bone, as the systemic administration of oxytocin prevents and reverses the bone loss induced by estrogen deficiency. Although oxytocin is involved in bone formation in both sexes during development, oxytocin treatment has no effect on male osteoporosis, underlining the importance of estrogen that amplifies its local autocrine and paracrine secretion. There are few human data showing a decrease in the oxytocin serum level in anorexia nervosa independently of estrogen and in amenorrheic women associated with impaired bone microarchitecture; in post-menopausal women a higher oxytocin serum level is associated with higher bone density, but not in osteoporotic men. Oxytocin displays many effects that may be beneficial in the management of osteoporosis, cardiovascular diseases, cognitive disorders, breast cancer, diabetes and body fat gain, all age-related diseases affecting elderly women, opening exciting therapeutic perspectives, although the issue is to find a single route, dosage and schedule able to reach all these targets.

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Section: Oxytocin As a Therapeutic Agent: Perspectivesmentioning

confidence: 99%

Oxytocin and Bone: Review and Perspectives

Breuil

Trojani

Amri

2021

IJMS

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“…Decreased bone formation is responsible for the pathogenesis of glucocorticoid-induced osteoporosis [ 123 ]. Recent evidence has shown that glucocorticoid administration enhances KLF15 expression, which leads to a reduction in osteoblast function [ 124 ].…”

Section: Roles Of Klfs In Normal Bone Physiology ( Table 1 ...mentioning

confidence: 99%

“…Osteoporosis is a systemic chronic pathology that requires long-term management after disease onset. Most osteoporotic patients are elderly; however, similar pathological conditions can be observed in patients undergoing long-term therapeutic glucocorticoid treatment (glucocorticoid-induced osteoporosis—GIO) [ 123 ]. The skeletons of patients show low bone mass and microstructural bone quality [ 146 ].…”

Section: Role Of Klfs In Osteoarthritis Osteoporosis and Osteosarcomamentioning

confidence: 99%

Kruppel-like Factors in Skeletal Physiology and Pathologies

Abe

Saeki

Ikeda

et al. 2022

IJMS

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Kruppel-like factors (KLFs) belong to a large group of zinc finger-containing transcription factors with amino acid sequences resembling the Drosophila gap gene Krüppel. Since the first report of molecular cloning of the KLF family gene, the number of KLFs has increased rapidly. Currently, 17 murine and human KLFs are known to play crucial roles in the regulation of transcription, cell proliferation, cellular differentiation, stem cell maintenance, and tissue and organ pathogenesis. Recent evidence has shown that many KLF family molecules affect skeletal cells and regulate their differentiation and function. This review summarizes the current understanding of the unique roles of each KLF in skeletal cells during normal development and skeletal pathologies.

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“…Osteoporosis is a major health problem, leading to fragility fractures which cause significant mortality in affected patients up to 3–4 times higher than the general population within one year after diagnosis 1 – 3 . With the growing ageing population, this results in substantially increasing costs to global health-care systems 4 . The goals of osteoporosis treatment are to reduce risk of osteoporotic fractures and improve bone mineral density (BMD), a gold standard tool for diagnosing osteoporosis and assessing response to therapy 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy

Tanphiriyakun

Rojanasthien

Khumrin

2021

Sci Rep

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Osteoporosis is a global health problem for ageing populations. The goals of osteoporosis treatment are to improve bone mineral density (BMD) and prevent fractures. One major obstacle that remains a great challenge to achieve the goals is how to select the best treatment regimen for individual patients. We developed a computational model from 8981 clinical variables, including demographic data, diagnoses, laboratory results, medications, and initial BMD results, taken from 10-year period of electronic medical records to predict BMD response after treatment. We trained 7 machine learning models with 13,562 osteoporosis treatment instances [comprising 5080 (37.46%) inadequate treatment responses and 8482 (62.54%) adequate responses] and selected the best model (Random Forests with area under the receiver operating curve of 0.70, accuracy of 0.69, precision of 0.70, and recall of 0.89) to individually predict treatment responses of 11 therapeutic regimens, then selected the best predicted regimen to compare with the actual regimen. The results showed that the average treatment response of the recommended regimens was 9.54% higher than the actual regimens. In summary, our novel approach using a machine learning-based decision support system is capable of predicting BMD response after osteoporosis treatment and personalising the most appropriate treatment regimen for an individual patient.

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Management of glucocorticoid‐induced osteoporosis: What is new?

Cited by 4 publications

References 38 publications

Oxytocin and Bone: Review and Perspectives

Oxytocin and Bone: Review and Perspectives

Kruppel-like Factors in Skeletal Physiology and Pathologies

Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy

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