Glucocorticoids play an important role in general growth and the maintenance of bone mass in the skeleton. Steroid therapy induces bone loss and influences the transcription of some regulatory factors determining the ratio of bone turnover. Glucocorticoids increase bone resorption and decrease bone formation which leads to diminishing bone mass and bone mineral density. Osteoporosis is globally one of the most common metabolic bone diseases, and has increasingly been recognized as being a major public health issue. Glucocorticoids increase the risk of rib and limb bone fractures by modifying and decreasing bone quality. Glucocorticoids are very often used as anti-inflammatory and immunosuppressive drugs for serious rheumatoid arthritis and other systemic diseases in large groups of young children, and Glucocorticoids therapy is also used for children and youth having asthma as well as being administered during pregnancy in order to improve lung morphology in premature fetuses. No glucocorticoid drugs which would act without negative side effects are currently available. This review presents the mechanisms of glucocorticoid action based on the latest research and newest factors controlling bone remodeling such as osteoprotegerin and osteoprotegerin-ligands.
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