Author/Editor | Dai, Klara; Pahor, Artur | |
Title | Glukokortikoidna osteoporoza | |
Translated title | Glucocorticoid induced osteoporosis | |
Type | članek | |
Source | In: Novosti v osteologiji : monografija III. Osteoloških dnevov z mednarodno udeležbo, 21. in 22. oktober 2011, Medicinska fakulteta Univerze v Mariboru Maribor : Univerzitetni klinični center | |
Publication year | 2011 | |
Volume | str. 47-52 | |
Language | slv | |
Abstract | Glukokortikoidi pospešujejo razgradnjo kosti, zavirajo nastajanje nove kostnine, zmanjšujejo absorpcijo kalcija iz črevesja, pospešujejo kalciurijo ter s tem pomembno zmanjšujejo mineralno kostno gostoto. Povečano tveganje za zlome je prisotno že pri odmerkih od 2,5 do 7,5 mg prednizolona ali ekvivalentov dnevno. Pri vsakem bolniku, pri katerem predvidevamo vsaj trimesečno zdravljenje z glukokortikoidi, je potrebno opraviti klinično oceno tveganja za zlome, merjenje kostne gostote in določitev koncentracije vitamina D. Poleg zdravega življenjskega sloga priporočamo vsem bolnikom, ki potrebujejo vsaj trimesečno zdravljenje z glukokortikoidi, preventivo osteoporoze z dodajanjem kalcija in vitamina D; tistim bolnikom, ki imajo že prisotno osteopenijo ali osteoporozo, pa priporočamo tudi zdravljenje osteoporoze.Glucocorticoids increase bone resorption, reduce bone formation, decrease intestinal calcium absorption, and increase renal calcium excretion. Glucocorticoid therapy is associated with an appreciable risk of bone loss. The increased risk of fracture has been reported with doses of prednisone or its equivalent as low as 2.5 to 7.5 mg daily. Any patient taking any dose of glucocorticoid with an anticipated duration of .3 months requires an evaluation, which includes assessment of clinical risk factors for fracture, bone mineral density (DXA) of the hip and spine, and measurement of serum 25-hydroxyvitamin D. For all patients receiving any dose of chronic glucocorticoid therapy or initiating glucocorticoids with an anticipated duration of >/= 3 months, we recommend calcium and vitamin D supplementation; we treat all patients who also have osteopenia or osteoporosis anytime during treatment with glucocorticoids. | |
Descriptors | Glucocorticoids Glukokortikoidi Osteoporosis Osteoporoza adverse effects Stranski učinki prevention and control therapy Preprečevanje in nadzor Zdravljenje |