Nephrol Dial Transplant (2001) 16: 479-482
© 2001 European Renal Association-European Dialysis and Transplant Association
Rapid Communication
Glucocorticoid decreases circulating osteoprotegerin (OPG): possible mechanism for glucocorticoid induced osteoporosis
1 Department of Nephrology, Jichi Medical School, Tochigi, 2 Research Institute of Life Sciences, Snow Brand Milk Products Co., Ltd, Tochigi, Japan
Abstract
Background. Osteoporosis is a well known side-effect of long-term treatment with glucocorticoids. However, the precise mechanism of this disorder is unclear. Recently, osteoprotegerin (OPG) [osteoclastogenesis inhibitory factor (OCIF)] has been identified as a novel cytokine, which inhibits differentiation and activation of osteoclast. In the present study, in order to clarify the roles of OPG in the development of glucocorticoid-induced osteoporosis, we measured circulating OPG before and after glucocorticoid therapy.
Methods. The study subjects were 12 patients (five males, seven females, 53.4±4.8 [SE] years) with various renal diseases that required glucocorticoid therapy. All patients received glucocorticoids for the first time. Treatment was initiated at an average dose of 32.5±3.0 mg per day. Serum OPG was measured using enzyme-linked immunosorbent assay (ELISA). Laboratory data, markers of bone metabolism and circulating OPG were compared before and after treatment for 4 weeks.
Results. Serum OPG prior to glucocorticoid therapy was positively and independently correlated with serum creatinine. Serum OPG decreased significantly (P<0.0001) from 1.03±0.14 to 0.77±0.12 ng/ml after short-term administration of glucocorticoids. Furthermore, serum osteocalcin as a marker of bone formation was also reduced markedly (P=0.001). On the other hand, there were no remarkable changes in serum calcium, total alkaline phosphatases, creatinine and intact parathyroid hormone in response to glucocorticoid administration.
Conclusion. These findings indicate that short-term administration of glucocorticoids significantly suppresses serum OPG and osteocalcin. It might participate in the development of glucocorticoid-induced osteoporosis via an enhancement of bone resorption and suppression of bone formation.
Keywords: osteoprotegerin (OPG); osteoclastogenesis inhibitory factor (OCIF); glucocorticoid-induced osteoporosis; bone formation; bone resorption
Notes
Correspondence and offprint requests to: Eiji Kusano MD, Department of Nephrology, Jichi Medical School, Minamikawachi, Tochigi 329-0498, Japan
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