BONE-DENSITY AND TURNOVER IN ADDISONS-DISEASE - EFFECT OF GLUCOCORTICOID TREATMENT

Osteoporosis is a well-known side-effect of chronic treatment with glu cocorticoids. We have studied vertebral bone mineral density (BMD) and biochemical markers of bone metabolism in 30 patients diagnosed of Ad dison's disease (AD) to determine the effect of long-term replacement treatment with hydrocortisone (30 mg/day) or prednisone (7.5 mg/day). Lumbar bone mineral density was measured with dual energy X-ray absorp tiometry in L-1-4 in two occasions, separated by 12 months. BMD in pre menopausal women and men with AD was similar to healthy controls and p ostmenopausal women had slightly lower results. Rate of change of bone density followed up over a period of 12 months was -0.82%. Bone loss was not influenced by duration or type of steroid treatment. Biochemic al parameters, serum calcium, alkaline phosphatase, osteocalcin, proco llagen type I, PTH and 25(OH)vitamin D were within normal limits. Our results show that in patients with AD, after replacement with low dose s of glucocorticoids there is no significative trabecular bone loss ne ither modifications in bone formation markers.