Glukokortikoidlere Bağlı Osteoporoz
Sekonder osteoporozun en yaygın şekli olan glukokortikoid kaynaklı osteoporoz (GOP), önemli bir iyatrojenik problemi oluşturur. İlk aylarda %5 kemik kaybı meydana gelir. En fazla kırık vertebra, proksimal femur ve kostalarda görülür. GK kullanımı, kemik metabolizmasında önemli olan osteoblast ve osteoklast arasındaki dengeyi osteoklastlar lehine değiştirir. GK kullanımı kalsiyumun bağırsaklardan emilimini azaltmaktadır. Kalsiyumun renal alımında da azalma meydana gelir. Sonuçta kan kalsiyumunun azalması
paratiroid hormon salınımını stimüle ederek kemik rezorpsiyonunu artırır. Glukokortikoidlerin kemik sağlığı üzerindeki olumsuz etkilerini önlemek veya en aza indirmek için tedavi hemen başlanmalıdır. D vitamini, kalsiyum takviyeleri ve bifosfonatlar tedavide kullanılmalıdır.
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