Long-Term Low-Dose Glucocorticoid Therapy in Hyperandrogenized Women: Utility and Effects on Bone Mineral Content and Hypothalamic-Pituitary-Adrenocorticai Function

Abstract

The effect of chronic low-dose glucocorticoid administration on bone mineral content and corticotrope reserve was investigated in 12 hyperandrogenized women treated with 1–6 mg oral evening doses of 16β-methylprednisone for 12–58 months. The hypothalamic-pituitary-adrenal axis was evaluated in 9 patients by a standard metyrapone test after 45–75 days off steroid therapy. All the patients had a normal rise in serum 11-deoxycortisol after metyrapone. Bone densitometry was assessed at the end of therapy using dual photon absorptiometry. No significant differences between patients and age-matched hyperandrogenic controls were found either in spine (1.048 ± 0.096 vs. 1.023 ± 0.175 g/cm²) or femoral neck (0.863 ± 0.115 vs. 0.899 ± 0.216 g/cm²), respectively. In conclusion, absence of quantitative bone mass reduction and normal corticotrope reserve were observed even after 58 months of daily steroid administration.