References

porozendo

Остеопороз и остеопатии

Osteoporosis and Bone Diseases

2072-26802311-0716

Endocrinology Research Centre

10.14341/osteo2012318-24

porozendo-4092

Research Article

Статьи

Articles

СОСТОЯНИЕ КОСТНО-МЫШЕЧНОЙ СИСТЕМЫ ПРИ ЭНДОГЕННОМ ГИПЕРКОРТИЦИЗМЕ

MUSCULOSKELETAL SYSTEM IN THE ENDOGENOUS HYPERCORTISOLISM

Dragunova

N V

aspirant otdeleniya neyroendokrinologii i osteopatiy

Belaya

Zh E

k.m.n., st.n.s. otdeleniya neyroendokrinologii i osteopatiy

jannabelaya@gmail.ru

Rozhinskaya

L Ya

zav. otdeleniem neyroendokrinologii i osteopatiy

2012

15122012

153

№3 (2012)

1824

2012

Dragunova N.V., Belaya Z.E., Rozhinskaya L.Y.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.osteo-endojournals.ru/jour/article/view/4092

Представлены современные данные литературы о патогенезе, клинических проявлениях и методах лечения вторичного остеопороза при эндогенном гиперкортицизме. Повышение уровня глюкокортикоидов приводит к потере костной массы, нарушению микроархитектоники и переломам при минимальной травме, главным образом из-за снижения костеобразования. Снижение половых гормонов и развитие миопатии снижает мышечную силу, увеличивает риск падений и усугубляет риск низкотравматичных переломов. За последние годы стали доступны новые экспериментальные данные, объясняющие эти изменения на уровне сигнальных путей RANK/RANKL/OPG, Wnt сигнального пути. В настоящем обзоре обсуждаются результаты этих работ, даются практические рекомендации и поднимаются вопросы для будущих исследований.

The authors review the current literature data on the pathogenesis, clinical manifestations and treatment of glucocorticoid induced osteoporosis in patients with endogenous hypercortisolism. High levels of glucocorticoids lead to bone loss, bone quality deterioration and low traumatic fractures as a consequence of reduced bone formation. In addition to this, muscle weakness and sex steroids hormone abnormalities increase the risk of falls and fractures. The new available data on possible mechanisms of these changes including the involvement of RANKL/RANK/OPG, Wnt-betacatenin signaling pathway and pathogenesis of myopathy are discussed. This review also outlines the practical recommendation and new questions that should be evaluated in future research.

References1

Cushing H. The basophil adenomas of the pituitary body and their clinical manifestations (pituitary basophilism) // Bulletin of the John Hopkins Hospital. - 1932. - Vol. 1. -Р. 137-192.

Mancini T., Doga M., Mazziotti G., Giustina A. Cushing’s syndrome and bone // Pituitary. - 2004. - Vol. 7. - Р. 249-252.

Guaraldi F., Salvatori R. Cushing Syndrome: Maybe Not So Uncommon of an Endocrine Disease // J Am Board Fam Med. - 2012. - Vol. 25. - Р. 199 -208.

Hardy R., Cooper M.S. Adrenal gland and bone // Archives of Biochemistry and Biophysics. - 2010. - Vol. 503. -Р. 137-145.

Kaltsas G., Manetti L., Grossman A.B. Osteoporosis in Cushing’s syndrome // Front Horm Res. - 2002. - Vol. 30. -Р. 60-72.

Lanna C.M.M., Paula F.J.A., Montenegro R.M. Jr. et al. Parathyroid hormone secretion in chronic human endogenous hypercortisolism // Brazilian Journal of Medicin and Biological Research. - 2002. - Vol. 35. - P. 229-236.

Mazziotti G., Angeli A., Bilezikian J.P., Canalis E., Giustina A. Glucocorticoid-induced osteoporosis: an update // Trends Endocrinol Metab. - 2006. - Vol. 17. - Р. 144-149.

Manelli F., Giustina A Glucocorticoidinduced osteoporosis // Trends Endocrinol Metab. - 2000. - Vol. 11. - Р. 79-85.

Kaltsas G.A., Korbonits M., Isidori A.M., Webb J.A.W., Trainer P.J., Monson J.P., Besser G.M., Grossman A.B. How common are polycystic ovaries and the polycystic ovarian syndrome in women with Cushing’s syndrome? // Clin Endocrinol (Oxf). - 2000. - Vol. 53. - Р. 493-500.

Barbetta L., Dall’Asta C., Re T., Colombo P., Travaglini P., Ambrosi B. Androgen secretion in ectopic ACTH syndrome and in Cushing’s disease: modifications before and after surgery // Horm Metab Res. - 2001. - Vol. 33. - Р. 596-601.

Minetto M., Reimondo G., Osella G., Ventura M., Angeli A., Terzolo M. Bone loss is more severe in primary adrenal than in pituitary-dependent Cushing’s syndrome // Osteoporos Int. - 2004. - Vol. 15. - Р. 855-861.

Kaji H., Yamauchi M., Chihara K., Sugimoto T Glucocorticoid Excess Affects Cortical Bone Geometry in Premenopausal, but not Postmenopausal, Women // Calcif Tissue Int. - 2008. - Vol. 82. - Р. 182-190.

Abu E.O., Horner A., Kusec V., Triffitt J.T., Compston J.E. The localization of the functional glucocorticoid receptor alpha in human bone // J Clin Endocrinol Metab. - 2000. - Vol. 85. -Р. 883-889.

Мякоткин В.А., Крылов М.Ю., Казеева А.Ю., Маслова К.А., Торопцова Н.В., Никитинская О.А., Беневоленская Л.И. Оценка значимости полиморфизмов генов LRP5, BMP4, TGFß1 при постменопаузальном остеопорозе // Научно-практическая ревматология. - 2008. - № 3. - С. 8-14.

Enrico M. Messalli, Cono Scaffa. New perspectives in the management of osteoporosis. Osteoporosis: etiology, diagnosis and treatment // Nova Biomedical Books. - 2009. -Ch. 6. - P. 145-156.

Castelo-Branco C., Gomez O., Pons F., Martinez de Osaba M.J., Balasch J., Antoni Vanrell J. Secreting ovarian tumors may protect women from osteoporosis // Gynecol Oncol. - 2003. -Vol. 88. - Р. 149-152.

Lekamwasam S., Adachi J.D., Agnusdei D., Bilezikian J., Boonen S., Borgstrom F., Cooper C., Diez Perez A., Eastell R., Hofbauer L.C., Kanis J.A., Langdahl B.L., Lesnyak O., Lorene R., McCloskey E., Messina O.D., Napoli N., Obermayer-Pietsch B., Ralston S.H., Sambrook P.N., Silverman S., Sosa M., Stepan J., Suppan G., Wahl D.A., Compston J.E., Joint IOF-ECTS GIO Guidelines Working Group 2012 A framework for the development of guidelines for the management of glucocorticoid-induced osteoporosis. Osteoporosis International, published online 21 March DOI: 10.1007/s00198-012-1958-1.

Canalis E. Mechanisms of glucocorticoid action in bone // Curr Osteoporos Rep. - 2005. - Vol. 3. - Р. 98-102.

Manolagas S.C. Corticosteroids and fractures: a close encounter of the third cell kind // J Bone Miner Res. - 2000. -Vol. 15. - Р. 1001-1005.

Lekva T., Bollerslev J., Kristo C., Olstad O.K., Ueland T., Jemtland R.: The glucocorticoidinduced leucine zipper gene (GILZ) expression decreases after successful treatment of patients with endogenous Cushing’s syndrome and may play a role in glucocorticoidinduced osteoporosis // J Clin Endocrinol Metab. - 2010. - Vol. 95. - Р. 246-255.

Morelli V., Donadio F., Eller-Vainicher C., Cirello V., Olgiati L., Savoca C., Cairoli E., Salcuni A.S., Beck-Peccoz P., Chiodini I. Role of glucocorticoid receptor polymorphism in adrenal incidentalomas // European Journal of Clinical Investigation. - 2010. - Vol. 40. - Р. 803-811.

Szappanos A., Patócs A., Tõke J., Boyle B., Sereg M., Majnik J., Borgulya G., Varga I., Likó I., Rácz K., Tóth M. BclI polymorphism of the glucocorticoid receptor gene is associated with decreased bone mineral density in patients with endogenous hypercortisolism // Clin Endocrinol (Oxf). - 2009. - Vol. 71. -Р. 636-643.

Dennison E., Hindmarsh P., Fall C., Kellingray S., Barker D., Phillips D., Cooper C Profiles of endogenous circulating Cortisol and bone mineral density in healthy elderly men // J Clin Endocrinol Metab. - 1999. - Vol. 84. - Р. 3058-3063.

Francucci C.M., Pantanetti P., Garrapa G.G., Massi F., Arnaldi G., Mantero F. Bone metabolism and mass in women with Cushing‘s syndrome and adrenal incidentaloma // Clinical Endocrinology. - 2002. - Vol. 57. - Р. 587-593.

Cetin A., Gokce-Kutsal Y., Celiker R. Predictors of bone mineral density in healthy males // Rheumatol. Int. - 2001. -Vol. 21. - Р. 85-88.

Greendale G.A., Unger J.B., Rowe J.W., Seeman T.E. The relation between cortisol excretion and fractures in healthy older people: results from the MacArthur studies-Mac // J Am Geriatr Soc. - 1999. - Vol. 47. - Р. 799-803.

Chiodini I., Morelli V., Masserini B. et al. Bone Mineral Density, Prevalence of Vertebral Fractures, and Bone Quality in Patients with Adrenal Incidentalomas with and without Subclinical Hypercortisolism: An Italian Multicenter Study // J Clin Endocrinol Metab. - 2009. - Vol. 94. - Р. 3207-3214.

Jiang Y., Meng X.W., Lu Z.L., Xia W.B., Xing X.P., Li M., Wang O., Yu W., Tian J.P. Bone loss is more severe in younger Cushing‘s syndrome women than in older ones: comparison of bone mineral density between Cushing‘s syndrome and healthy women // Zhonghua Yi Xue Za Zhi. - 2007. - Vol. 26. - Р. 1695-1697.

Eller-Vainicher C., Morelli V., Ulivieri F.M., Palmieri S., Zhukouskaya V.V., Cairoli E., Pino R., Naccarato A., Scillitani A., Beck-Peccoz P., Chiodini I. Bone quality, as measured by Trabecular Bone Score (TBS), in patients with adrenal incidentalomas with and without subclinical hypercortisolism // J Bone Miner Res - 2012 // http://www.ncbi.nlm.nih.gov/pubmed/22549969.

Arnaldi G., Angeli A., Atkinson A.B., et al. Diagnosis and complications of Cushing’s syndrome: a consensus statement // J Clin Endocrinol Metab. - 2003. - Vol. 88. - Р. 5593-5602.

Belaya Z., Dragunova N., Rozhinskaya L., Melnichenko G. Secondary osteoporosis: fractures and bone remodeling in patients with endogenous hypercortisolism. A link to the pathogenesis of glucocorticoid - induced osteoporosis // Osteoporosis. Risk fractures, symptoms and management. By editors Romero A. and Ortega V. - New York: Nova Science Publishers. - 2012. - Р. 127-143.

Vestergaard P., Lindholm J., Jorgensen J.O. et al. Increased risk of osteoporotic fractures in patients with Cushing’s syndrome // Eur. J. Endocrinol. - 2002. - Vol. 146. - P. 51-56.

Tauchmanova L., Pivonello R., Di Somma C. Bone Demineralization and Vertebral Fractures in Endogenous Cortisol Excess: Role of Disease Etiology and Gonadal Status // J Clin Endocrinol Metab. - 2006. - Vol. 91. - Р. 1779-1784.

Chiodini I., Viti R., Coletti F. et al. Eugonadal male patients with adrenal incidentalomas and subclinical hypercortisolism have increate rate of vertebral fractures // Clin Endocrinol (Oxf.). - 2009. - Vol. 70. - P. 208-213.

Chiodini I., Mascia M.L., Muscarella S. Subclinical Hypercortisolism among Outpatients Referred for Osteoporosis // Ann Intern Med. - 2007. - Vol. 147. - Р. 541-548.

van der Eerden A.W., den Heijer M., Oyen W.J., Hermus A.R. Cushing’s syndrome and bone mineral density: lowest Z scores in young patients // The Netherlands Journal of Medicine. - 2007. - Vol. 65. - P. 136-141.

Di Somma C., Pivonello R., Loche S., et al. Effect of 2 years of cortisol normalization on the impaired bone mass and turnover in adolescent and adult patients with Cushing’s disease: a prospective study // Clin Endocrinol (Oxf ). - 2003. - Vol. 58. - Р. 302-308.

Stewart A., Kumar V., Reid D.M. Long-term fracture prediction by DXA and QUS: a 10-year prospective study // J Bone Miner Res. - 2006. - Vol. 21. - Р. 413-418.

Lang C.H., Silvis C., Nystrom G., and Frost R.A. Regulation of myostatin by glucocorticoids after thermal injury // FASEB J. - 2001. - Vol. 15. - Р. 1807-1809.

Rios R., Carneiro I., Arce V.M., and Devesa J. Myostatin regulates cell survival during C2C12 myogenesis // Biochem Biophys Res Commun. - 2001. - Vol. 280. - Р. 561-566.

Rios R., Carneiro I., Arce V.M., and Devesa J. Myostatin is an inhibitor of myogenic differentiation // Am J Physiol Cell Physiol. - 2002. - Vol. 282. - P. C993-C999.

Minetto M.A., Botter A., Lanfranco F., Baldi M., Ghigo E. & Arvat E. Muscle fiber conduction slowing and decreased levels of circulating muscle proteins after short-term dexamethasone administration in healthy subjects // Journal of Clinical Endocrinology and Metabolism. - 2010. - Vol. 95. - Р. 1663-1671.

van der Hoeven J.H. Decline of muscle fiber conduction velocity during short-term high-dose methylprednisolone therapy // Muscle and Nerve. - 1996. - Vol. 19. - Р. 100-102.

Minetto M.A., Lanfranco F., Botter A. et al. Do muscle fiber conduction slowing and decreased levels of circulating muscle proteins represent sensitive markers of steroid myopathy? A pilot study in Cushing’s disease // European Journal of Endocrinology. - 2011. - Vol. 164. - Р. 985-993.

Orwoll E., Lambert L.C., Marshall L.M., Blank J., Barrett-Connor E., Cauley J., Ensrund K. & Cummings S.R. Endogenous testosterone levels, physical performance, and fall risk in older men // Archives of Internal Medicine. - 2006. - Vol. 166. - Р. 2124-2131.

Pivonello R., De Martino M.C., De Leo M., Tauchmanovà L., Faggiano A., Lombardi G., Colao A. Cushing‘s syndrome: aftermath of the cure. // Arq Bras Endocrinol Metabol. 2007, 51: 1381-1391.

Füto L., Toke J., Patócs A., Szappanos A., Varga I., Gláz E., Tulassay Z., Racz K., Tóth M. Skeletal differences in bone mineral area and content before and after cure of endogenous Cushing‘s syndrome // Osteoporos Int. - 2008. - Vol. 19. - Р. 941-949.

Chiodini I., Guglielmi G., Battista C. et al. Spinal volumetric bone mineral density and vertebral fractures in female patients with adrenal incidentalomas: the effects of subclinical hypercortisolism and gonadal status // J Clin Endocrinol Metab. - 2004. - Vol. 89. - P. 2237-2241.

Tauchmanova L., Pivonello R., De Martino M.C. et al. Effects of sex steroids on bone in women with subclinical or overt endogenous hypercortisolism // Eur J Endocrinol. - 2007. - Vol. 157. - P. 359-366.

Мороз В.А., Ланько Л.Г. Бисфосфонаты в современной клинической практике // Провизор. - 2009. - № 8.

Teitelbaum S.L., Seton M.P., Saag K.G. Should Bisphosphonates Be Used for Long-Term Treatment of Glucocorticoid-Induced Osteoporosis? // Arthritis & Rheumatism. - 2011. - Vol. 63. - P. 325-328.

Reszka A.A., Rodan G.A. Nitrogen-containing bisphosphonate mechanism of action. // Mini Rev Med Chem. - 2004. - Vol. 4. - P. 711-718.

Hochberg M.C., Greenspan S., Wasnich R.D., et al. Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. // J Clin Endocrinol Metab. - 2002. - Vol. 87. - P. 1586-1592.

Im G.I., Qureshi S.A., Kenney J. et al. Osteoblast proliferation and maturation by bisphosphonates // Biomaterials. - 2004. - Vol. 25. - P. 4105-4115.

O’Brien C.A., Jia D., Plotkin L.I. et al. Glucocorticoid act directly on osteoblasts and osteocytes to induce their apoptosis and reduce bone formation and strength // Endocrinology. - 2004. - Vol. 145. - P. 1835-1841.

Tauchmanova L., Guerra E., Pivonello R., De Martino M.C., De Leo M., Caggiano F., Lombardi G., Colao A. Weekly clodronate treatment prevents bone loss and vertebral fractures in women with subclinical Cushing‘s syndrome // J Endocrinol Invest. - 2009. - Vol. 32. - Р. 390-394.

Rogers M.J. New insights into the molecular mechanism of action of bisphosphonates. // Curr Pharm Res. - 2003. -Vol.11. - P. 196-204.

Brumsen C., Papapoulos S.E., Lips P., et al. Daily oral pamidronate in women and men with osteoporosis: a 3-year randomised, placebocontrolled clinical trial with a 2-year extension. // J Bone Miner Res. - 2002. - Vol. 17. -P. 1057-1064.

Tee S.-I., Yosipovitch G., Chan Y.C. Prevention of Glucocorticoid-Induced Osteoporosis in Immunobullous Diseases With Alendronate // Arch Dermatol. - 2012. - Vol. 148. - Р. 307-314.

Papapoulos S.E., Schimmer R.C. Изменения костного ремоделирования и эффективность в плане предотвращения переломов на фоне интермиттирующего приёма бисфосфонатов: результаты клинических исследований ибандроната // Сибирский медицинский журнал. - 2007. -№ 7. - С. 6-11.

Hayashi K., Yamaguchi T., Yano S., Kanazawa I., Yamauchi M., Yamamoto M., Sugimoto T. BMP/Wnt antagonists are upregulated by dexamethasone in osteoblasts and reversed by alendronate and PTH: Potential therapeutic targets for glucocorticoid-induced osteoporosis // Biochemical and Biophysical Research Communications. - 2009. - Vol. 379. - Р. 261-266.

Wang F.-S., Lin C.-L., Chen Y.-J., Wang C.-J., Yang K.D., Huang Y.-T., Sun Y.-C., Huang H.-C. (2005) Secreted frizzled-related protein 1 modulates glucocorticoid attenuation of osteogenic activities and bone mass. J. Endocrinology 146: 2415-2423.

Wang F.-S., Ko J.-Y., Yeh D.-W., Ke H.-C., Wu H.-L. (2008) Modulation of dickkopf-1 attenuates glucocorticoid induction of osteoblast apoptosis, adipocytic differentiation and bone mass loss. Endocrinology 149: 1793-1801.

Eastell R., Chen P., Saag K.G., Burshell A.L., Wong M., Warner M.R., Krege J.H. Bone formation markers in patients with glucocorticoid-induced osteoporosis treated with teriparatide or alendronate // Bone. - 2010. - Vol. 46. - Р. 929-934.

Di Somma C., Colao A., Pivonello R., et al. Effectiveness of chronic treatment with alendronate in the osteoporosis of Cushing‘s disease // Clinical Endocrinology. - 1998. -Vol. 48. - Р. 655-662.

McClockey E., Selby P., Davis M. et al. Clodronate reduces vertebral fracture risk in women with postmenopausal or secondary osteoporosis: results of a double-blind, placebocontrolled 3-year study // J Bone Miner res. - 2004. -Vol. 19. - P. 728-736.

Рожинская Л.Я. Остеопенический синдром при заболеваниях эндокринной системы и постменопаузальный остеопороз: патогенетические аспекты, диагностика и лечение. Дис. Док. Мед. Наук. - Москва. - 2002.

Марова Е.И., Арапова С.Д., Белая Ж.Е., Рожинская Л.Я., Колесникова Г.С. Болезнь Иценко-Кушинга (клиника, диагностика, лечение). Практическое руководство для врачей. Под редакцией Академика РАН и РАМН Дедова И.И. и Академика РАМН Мельниченко Г.А. Москва, 2012., - С. 50-51.

Bone H.G., Hosking D., Devogalaer J.-P., et al. Ten years’ experience with alendronate for osteoporosis in postmenopausal women. // N Engl J Med. - 2004. - Vol. 350. - P. 1189-1199.

Delmas P.D., Recker R.R., Chesnut C.H., et al. Daily and intermittent oral ibandronate normalize bone turnover and provide signifi cant reduction in vertebral fracture risk: results from the BONE study. // Osteoporosis Int. - 2004. -Vol. 15. - P. 792-798.

Mellstrom D.D., Sorenson O.H., Goemaere S., et al. Seven years of treatment with risedronate in women with postmenopausal osteoporosis. // Calcif Tissue Int. - 2004. -Vol. 75. - P. 462-468.

Dore R.K. How to prevent glucocorticoid-induced osteoporosis // Cleveland Clinical Journal of Medicine. - 2010. - Vol. 77. - P. 529-538.

The authors declare that there are no conflicts of interest present.