Glucocorticosteroid-induced osteoporosis: pathogenesis, prevention, treatment

Abstract

Glyukokortikoidindutsirovannyy osteoporoz (GIO) - odno iz naibolee tyazhelykh oslozhneniy dlitel'noy (bolee 3 mes) sistemnoy terapii glyukokortikoidami (SGK). On razvivaetsya u bol'nykh lyubogo vozrasta i pola i yavlyaetsya naibolee chastoy sistemnoy formoy vtorichnogo osteoporoza (OP). Bystraya poterya kostnoy massy proiskhodit uzhe v pervye mesyatsy lecheniya SGK. Perelomy ot minimal'noy travmy voznikayut pri bolee vysokikh pokazatelyakh mineral'noy plotnosti kosti, chem u bol'nykh pervichnym OP. Dazhe ispol'zovanie malykh doz SGK privodit k povysheniyu riska perelomov, s uvelicheniem sutochnoy dozy risk perelomov vozrastaet. U patsientov, primenyayushchikh vysokie dozy ingalyatsionnykh GK (IGK), uvelichenie riska OP i perelomov v bol'shey stepeni obuslovleno tyazhest'yu respiratornogo zabolevaniya, chem terapiey IGK. Predstavleny sovremennye printsipy profilaktiki i lecheniya GIO.