The role of growth hormone in glucocorticoid-induced osteoporosis

Glucocorticoid-induced osteoporosis (GIO) is the most common form of secondary osteoporosis. GC influence bone metabolism via a modulation of different components of the GH/IGF-I system. GH has multiple anabolic effects on bone, either direct or mediated by IGF-I. GH-deficient subjects have significant reduction in bone mineralization, bone turnover markers, and increased fracture risk when compared with healthy age-matched controls. The increase of bone remodeling achieved by recombinant human GH (rhGH) therapy may be helpful in both males and females with decreased bone turnover and impaired osteoblastic function such as subjects with GC excess. rhGH treatment may improve lean body mass and skeletal muscle mass that may further reduce fracture risk in GIO patients. Nevertheless, the real efficacy of rhGH and IGF-I treatment in GIO and during aging is still controversial and further well-designed prospective controlled studies are necessary in order to clarify this issue, thus identifying who could potentially benefit from GH treatment.