СОСТОЯНИЕ КОСТНО-МЫШЕЧНОЙ СИСТЕМЫ ПРИ ЭНДОГЕННОМ ГИПЕРКОРТИЦИЗМЕ

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.

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