Understanding and managing secondary osteoporosis

Colangelo, Luciano; Biamonte, Federica; Pepe, Jessica; Cipriani, Cristiana; Minisola, Salvatore

doi:10.1080/17446651.2019.1575727

Cited by 31 publications

(21 citation statements)

References 102 publications

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“…Chronic kidney disease (CKD) is a common complication in diabetic patients. The intricacy between CKD and bone configures a specific metabolic disorder, the CKD-Mineral Bone Disorder (CKD-MBD), that plays an important role in the skeletal fragility associated with diabetes (26).…”

Section: Systemic Mechanismsmentioning

confidence: 99%

The Interplay Between Bone and Glucose Metabolism

et al. 2020

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The multiple endocrine functions of bone other than those related to mineral metabolism, such as regulation of insulin sensitivity, glucose homeostasis, and energy metabolism, have recently been discovered. In vitro and murine studies investigated the impact of several molecules derived from osteoblasts and osteocytes on glucose metabolism. In addition, the effect of glucose on bone cells suggested a mutual cross-talk between bone and glucose homeostasis. In humans, these mechanisms are the pivotal determinant of the skeletal fragility associated with both type 1 and type 2 diabetes. Metabolic abnormalities associated with diabetes, such as increase in adipose tissue, reduction of lean mass, effects of hyperglycemia per se, production of the advanced glycation end products, diabetes-associated chronic kidney disease, and perturbation of the calcium-PTH-vitamin D metabolism, are the main mechanisms involved. Finally, there have been multiple reports of antidiabetic drugs affecting the skeleton, with differences among basic and clinical research data, as well as of anti-osteoporosis medication influencing glucose metabolism. This review focuses on the aspects linking glucose and bone metabolism by offering insight into the most recent evidence in humans.

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Section: Systemic Mechanismsmentioning

confidence: 99%

The Interplay Between Bone and Glucose Metabolism

et al. 2020

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“…However, it is not only the increase of falls frequency that the fracture risk is associated with. The stroke patients have their BMD values which are lower than the general population ones [5,15,19,33]; however, when and how this reduction occurs is disputable. The 2 SD BMD decrease at the proximal hip bone site increases the falls-related fracture risk of the Лекції, огляди / Lectures, Reviews stroke patients by 7 times [30].…”

Section: Osteoporosis In Stroke Patientsmentioning

confidence: 98%

Сучасний Погляд На Остеопороз В Умовах Неврологічної Патології (Огляд Літератури)

Bystrytska¹

2021

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The article presents the current literature data of the nervous system's pathology influence on bone metabolism. The nervous system diseases proven to affect bone and increase the risk of osteoporosis and fractures are epilepsy, multiple sclerosis, stroke, spinal cord injury, Parkinson's disease and muscular dystrophy. Study of the mechanisms of osteoporosis formation in this category of patients is ongoing, the new views of the increased fracture risk causes appear, and therefore new trends in prevention and treatment are required.

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“…The source of cortisol may be endogenous as adrenal and pituitary tumour derived or exogenous since glucocorticoids are used in many rheumatologic, dermatological, lung, etc conditions (13,14,15). Regardless the origin of the glucocorticoids excess, the mechanisms of bone loss includes reduced bone formation and increased bone resorption which is time-dependent as well as dose-dependent (16,17,18). DXA (Dual-Energy X-Ray Absorptiometry) is a useful tool to evaluate the bone loss but sometimes it underestimates the fracture risk (16).…”

Section: Glucocorticoid Osteoporosismentioning

confidence: 99%

Osteoporosis and adrenal incidentaloma: To be or not to be?

Şandru¹,

Dumitrașcu²,

Albu³

et al. 2019

Ro J Med Pract.

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Introduction. Adrenal incidentaloma is a more frequent diagnosis during the last decades since the relative access to abdominal ultrasound, computed tomography or magnetic resonance imagery is higher. Aim. Our aim is to focus on the relationship between bone status (BS) in patients diagnosed and confirmed with adrenal incidentaloma. Method. This is a mini-review of the literature. Most of the included papers were published during the last 5 years. The main research tool is PubMed database. General data. BS is affected in adrenal incidentaloma mainly through persistent autonomous cortisol production which is called (even lately the term is not encouraged) "subclinical Cushing's syndrome" with a prevalence of 0.2 up to 2% in unselected series of adult people. TBS (Trabecular Bone Score) in both men and women is negatively correlated with plasma cortisol after 1 mg dexamethasone suppression test. There is 2.2% decrease of TBS if subclinical Cushing's syndrome is confirmed opposite to clear non-functioning pattern of the adrenal incidenaloma. Bone mineral density based on DXA at central sites (lumbar spine and femoral neck) was similar between the subject with unilateral and bilateral incidentaloma. The presence of subliclinical hypercortisolism is positively correlated with a higher risk of osteoporosis and fragility fractures Recently the term of "high risk" patients with adrenal incidentaloma has been introduced in order to describe the subgroup with autonomous cortisol secretion that has an increased risk of cardiovascular morbidities, infections and fractures (even independently of DXA-bone mineral density. Conclusion. The main contributor to BS, as well as to the cardiometabolic damage, remains the autonomous cortisol secretion in adrenal incidentaloma with a potential improvement after adrenalectomy and without a specific anti-osteoporotic medication in this particular situation.

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Understanding and managing secondary osteoporosis

Cited by 31 publications

References 102 publications

The Interplay Between Bone and Glucose Metabolism

The Interplay Between Bone and Glucose Metabolism

Сучасний Погляд На Остеопороз В Умовах Неврологічної Патології (Огляд Літератури)

Osteoporosis and adrenal incidentaloma: To be or not to be?

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