Glucocorticoid Excess in Bone and Muscle

Amy Y. Sato, Munro Peacock, Teresita Bellido

Research output: Contribution to journalReview articlepeer-review

14 Scopus citations


Glucocorticoids (GC), produced and released by the adrenal glands, regulate numerous physiological processes in a wide range of tissues. Because of their profound immunosuppressive and anti-inflammatory actions, GC are extensively used for the treatment of immune and inflammatory conditions, the management of organ transplantation, and as a component of chemotherapy regimens for cancers. However, both pathologic endogenous elevation and long-term use of exogenous GC are associated with severe adverse effects. In particular, excess GC has devastating effects on the musculoskeletal system. GC increase bone resorption and decrease formation leading to bone loss, microarchitectural deterioration, and fracture. GC also induce loss of muscle mass and strength leading to an increased incidence of falls. The combined effects on bone and muscle account for the increased fracture risk with GC. This review summarizes the advance in knowledge in the last two decades about the mechanisms of action of GC in bone and muscle and the attempts to interfere with the damaging actions of GC in these tissues with the goal of developing more effective therapeutic strategies.

Original languageEnglish (US)
Pages (from-to)33-47
Number of pages15
JournalClinical Reviews in Bone and Mineral Metabolism
Issue number1
StatePublished - Mar 1 2018


  • Apoptosis
  • Fracture
  • Glucocorticoids
  • Muscle atrophy
  • Myopathy
  • Osteoblast
  • Osteoclast
  • Osteocyte
  • Osteonecrosis
  • Osteoporosis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Orthopedics and Sports Medicine
  • Endocrinology

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