Abstract
Cushing's syndrome, both endogenous and exogenous (iatrogenic), is associated with a decrease of bone mass called as glucocorticoid-induced osteoporosis. Among factors playing role in its pathogenesis are: inhibition of bone formation and stimulation of osteoresorption, disturbed bone remodelation, disturbed calcium-phosphate metabolism with negative calcium balance and also disturbed vitamin D metabolism.
Prevention of glucocorticoid-induced osteoporosis consists of identification of subjects at increased risk of fractures and introducing measures leading to its decrease. Therapy includes non-pharmacological measures and sufficient intake of calcium and vitamin D.
As the first line in medical treatment are recommended bisphosphonates or teriparatide, after discontinuation of teriparatide bisphosphonates or denosumab.