Fig. 1.
Pathophysiology of glucocorticosteroid-induced osteoporosis. Glucocorticosteroids exert direct deleterious effects on bone leading to decreased formation and increased resorption. In addition, bone loss may be indirectly promoted by reduced gonadal hormone levels and by myopathy as well as by decreased calcium absorption from the gut and increased renal calcium excretion. However, secondary hyperparathyroidism is an inconstant finding