Steroid Myopathy: Pathogenesis and Effects of Growth Hormone and Insulin-Like Growth Factor-I Administration

Kanda, Fumio; Okuda, Shiho; Matsushita, Tatsuo; Takatani, Keiko; Kimura, Ken‐ichi; Chihara, Kazuo

doi:10.1159/000048130

Cited by 54 publications

(34 citation statements)

References 47 publications

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“…It is estimated that more than 1% of the US population is treated chronically with GC steroids. Although the side effect profile from GC steroids is extensive, muscle weakness and myopathy can occur in response to chronic GC steroid use and can be extremely debilitating (1). Curiously, chronic GC steroids are used to treat Duchenne muscular dystrophy (DMD), a primary muscle disease, and the use of steroids is associated with prolonged ambulation (2,3).…”

Section: Introductionmentioning

confidence: 99%

Intermittent glucocorticoid steroid dosing enhances muscle repair without eliciting muscle atrophy

Quattrocelli¹,

Barefield²,

Warner³

et al. 2017

Journal of Clinical Investigation

104

125

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Section: Introductionmentioning

confidence: 99%

Intermittent glucocorticoid steroid dosing enhances muscle repair without eliciting muscle atrophy

Quattrocelli¹,

Barefield²,

Warner³

et al. 2017

Journal of Clinical Investigation

104

125

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“…Steroid myopathy is a well-known sign of Cushing's syndrome (1)(2)(3). It has a typical pattern of muscle weakness affecting the lower limbs more than the upper limbs and the proximal part of a limb more than the distal part (4).…”

Section: Introductionmentioning

confidence: 99%

Do muscle fiber conduction slowing and decreased levels of circulating muscle proteins represent sensitive markers of steroid myopathy? A pilot study in Cushing's disease

Minetto¹,

Lanfranco²,

Botter³

et al. 2011

European Journal of Endocrinology

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Objective: Glucocorticoids are known to decrease protein synthesis and conduction velocity of muscle fibers. However, the degree of impairment of muscle protein synthesis and conduction slowing in patients with Cushing's disease remains poorly characterized. Our objective was to investigate whether and to what extent chronic endogenous hypercortisolism could decrease the circulating levels of muscle proteins and modify myoelectric indexes of sarcolemmal excitability and fatigability. Design: A total of ten patients with Cushing's disease and 30 healthy controls matched for age, sex, and body mass index were compared. Methods: Blood sampling and electrophysiological tests on vastus lateralis, vastus medialis, and tibialis anterior muscles were performed. Results: Serum creatine kinase (CK) and plasma myoglobin were significantly lower in patients with respect to controls (P!0.001 and P!0.05 respectively): the mean relative difference between patients and controls was 48.9% for CK and 21.4% for myoglobin. Muscle fiber conduction velocity (MFCV) and myoelectric manifestations of fatigue were significantly decreased in all muscles of the patients with respect to controls. The mean relative difference in MFCV between patients and controls was 26.0% for vastus lateralis, 22.9% for vastus medialis, and 11.6% for tibialis anterior. These differences contrasted with the paucity of signs suggestive of myopathy that were obtained by needle electromyography in the patients. Conclusions: Slowing of muscle fiber conduction and decreased levels of circulating muscle proteins are sensitive markers of impaired muscle function, which are suitable for use in combination with clinical assessment and standard electrodiagnostic tests for accurate identification and follow-up of myopathic patients. 164 985-993 European Journal of Endocrinology

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“…Three mechanisms for the increased fracture rate in glucocorticoid-induced osteoporosis have been suggested: apoptosis of osteoblasts and osteocytes; marked alteration of bone turnover; and non-skeletal mechanisms such as increased risk of falls (42). Glucocorticoids are also known to cause muscle weakness, in the form of "steroid myopathy" (21), and muscle weakness is considered one of the major risk factors for falls (29). Increased fall risk is associated with declines in muscle strength and, when combined with increased bone fragility, further increases the susceptibility of the individual to fracture (47).…”

mentioning

confidence: 99%

Effects of a vitamin D analog, alfacalcidol, on bone and skeletal muscle in glucocorticoid-treated rats

et al. 2010

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Glucocorticoids cause secondary osteoporosis and myopathy. The efficacy of vitamin D on osteoporotic fractures is thought to be through direct effects on bone and indirect effects on muscles that help to prevent falls. However, effects of vitamin D on muscles under glucocorticoid treatment remain unclear. Six-month-old female Wistar rats were randomized to four groups: vehicletreated controls; a prednisolone (PSL)-administered group (PSL group); an alfacalcidol-administered group (D group); and a group administered both PSL and alfacalcidol (PSL+D group). After a 4-week treatment period, maximum contractile strength and strength decrement index (SDI), an indicator of muscle fatigue, were measured in the calf muscle by electrical stimulation of the sciatic nerve. Cross-sectional area (CSA) of muscle fibers in the tibialis anterior muscle and bone mineral density (BMD) of the femur were evaluated. The PSL group showed significantly lower muscle strength, BMD and CSA of muscle fibers, and significantly higher SDI compared to the other three groups (P < 0.05). No significant differences were observed in any of these parameters among control, D, and PSL+D groups. These results suggest that in glucocorticoid-treated rats, alfacalcidol preserved not only BMD, but also muscle strength and muscle volume, and prevented muscle fatigue.

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Steroid Myopathy: Pathogenesis and Effects of Growth Hormone and Insulin-Like Growth Factor-I Administration

Cited by 54 publications

References 47 publications

Intermittent glucocorticoid steroid dosing enhances muscle repair without eliciting muscle atrophy

Intermittent glucocorticoid steroid dosing enhances muscle repair without eliciting muscle atrophy

Do muscle fiber conduction slowing and decreased levels of circulating muscle proteins represent sensitive markers of steroid myopathy? A pilot study in Cushing's disease

Effects of a vitamin D analog, alfacalcidol, on bone and skeletal muscle in glucocorticoid-treated rats

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