Abstract
Osteoporosis is a well-known side-effect of chronic treatment with glucocorticoids. We have studied vertebral bone mineral density (BMD) and biochemical markers of bone metabolism in 30 patients diagnosed of Addison's disease (AD) to determine the effect of long-term replacement treatment with hydrocortisone (30 mg/day) or prednisone (7.5 mg/day). Lumbar bone mineral density was measured with dual energy X-ray absorptiometry in L-1-4 in two occasions, separated by 12 months. BMD in premenopausal women and men with AD was similar to healthy controls and postmenopausal women had slightly lower results. Rate of change of bone density followed up over a period of 12 months was -0.82%. Bone loss was not influenced by duration or type of steroid treatment. Biochemical parameters, serum calcium, alkaline phosphatase, osteocalcin, procollagen type I, PTH and 25(OH)vitamin D were within normal limits. Our results show that in patients with AD, after replacement with low doses of glucocorticoids there is no significative trabecular bone loss neither modifications in bone formation markers.
Publication types
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Clinical Trial
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Controlled Clinical Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Absorptiometry, Photon
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Addison Disease / drug therapy*
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Addison Disease / metabolism*
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Addison Disease / physiopathology
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Adult
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Aged
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Alkaline Phosphatase / blood
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Alkaline Phosphatase / metabolism
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Biomarkers / analysis
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Bone Density / physiology*
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Bone and Bones / metabolism*
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Bone and Bones / physiology
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Calcitriol / blood
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Calcitriol / metabolism
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Calcium / blood
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Calcium / metabolism
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Dose-Response Relationship, Drug
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Female
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Glucocorticoids / adverse effects
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Glucocorticoids / therapeutic use*
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Humans
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Hydrocortisone / adverse effects
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Hydrocortisone / therapeutic use
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Male
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Middle Aged
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Osteocalcin / blood
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Osteocalcin / metabolism
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Parathyroid Hormone / blood
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Parathyroid Hormone / metabolism
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Postmenopause / metabolism
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Prednisone / adverse effects
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Prednisone / therapeutic use
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Premenopause / metabolism
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Procollagen / blood
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Procollagen / metabolism
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Time Factors
Substances
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Biomarkers
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Glucocorticoids
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Parathyroid Hormone
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Procollagen
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Osteocalcin
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Alkaline Phosphatase
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Calcitriol
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Calcium
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Prednisone
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Hydrocortisone