Journal Article

Glucocorticoid decreases circulating osteoprotegerin (OPG): possible mechanism for glucocorticoid induced osteoporosis

Nobuhiro Sasaki, Eiji Kusano, Yasuhiro Ando, Kazuki Yano, Eisuke Tsuda and Yasushi Asano

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 16, issue 3, pages 479-482
Published in print March 2001 | ISSN: 0931-0509
Published online March 2001 | e-ISSN: 1460-2385 | DOI:
Glucocorticoid decreases circulating osteoprotegerin (OPG): possible mechanism for glucocorticoid induced osteoporosis

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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

Journal Article.  1608 words.  Illustrated.

Subjects: Nephrology

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