Endocrine Abstracts

The association between inflammatory bowel disease (IBD) and osteoporosis has been known for many decades but has only recently received appropriate recognition. This has largely resulted from the increasing awareness of the high morbidity and mortality attributable to osteoporosis in the general population and the application of advances in its detection to populations with gastrointestinal disease Recent population-based studies in individuals with inflammatory bowel disease...

Glucocorticoids have potent but paradoxical effects on bone. In vitro they are required for the differentiation of osteoblasts but in excess can cause suppression of the mature osteoblast phenotype by reducing proliferation and inducing apoptosis. In vivo, glucocorticoids are anabolic at physiological concentrations, but in excess have an adverse effect on the skeleton most clearly seen in steroid-induced osteoporosis. We have postulated that this paradox may be ...

All of the new drugs that have been used or become available over the past decade for the prevention and treatment of osteoporosis are so-called “anti-resorptives”. These include bisphosphonates (etidronate, alendronate and risedronate), hormone replacement therapy, selective estrogen receptor modulators (raloxifene), and calcitonins. All reduce vertebral fracture risk and some reduce nonvertebral fracture risk, but there are obvious theoretical advantages to using...

The statins may act on bone by the inhibition of bone resorption and the stimulation of bone formation. There is some clinical evidence to support these actions. There appears to be a reduction in the risk of fractures in patients taking statins, based on observational studies. There appears to be a small improvement in bone mineral density and a small increase in bone formation markers in patients taking statins. However, in the randomised controlled trials, there appears to ...