Purpose:To review the clinical picture, pathogenesis, and management of glucocorticoid-induced osteoporosis. Data Identification:Studies published since 1970 were identified from a MEDLINE...

Glucocorticoid-induced osteoporosis: pathogenesis and management.

Increased vascular permeability: a major cause of hypoalbuminaemia in disease and injury.

Although it is self-evident that the study of human nutrition has as its goal the optimal nutrition of man, the nutritional status of the body best suited to optimal performance, i.e., optimal nutrition, has unfortunately not yet been satisfactorily defined. Body composition of animals may be measured by direct chemical analysis and correlated with dietary intake and with the various aspects of performance; studies of body composition of living man, on the other hand, must rely on indirect measure ments. The following two reports, which give an account of the current status of the attack on the difficult task of measuring body composition in living man, are sponsored by the Committee on Nutrition to call attention to the resurgence of effort in this field during recent years. A fuller knowledge of the gross composition of the human body and its relation to preceding diet will constitute a significant step towards realization of the ultimate goal of nutritional science. Even then, a particular body composition will be of importance primarily in terms of functional performance. The availability of newer techniques should do much to stimulate physicians and nutritionists in defining body composition as an essential step in arriving at a more exact definition of optimal nutrition.

https://pediatrics.aappublications.org/content/pediatrics/29/3/476.full.pdf

Human body composition

The natural history of Cushing's syndrome.

Glucocorticoid action on target tissues is determined by the density of “nuclear” receptors and intracellular metabolism by the two isozymes of 11β-hydroxysteroid dehydrogenase (11β-HSD) which catalyze interconversion of active cortisol and corticosterone with inert cortisone and 11-dehydrocorticosterone. 11β-HSD type 1, a predominant reductase in most intact cells, catalyzes the regeneration of active glucocorticoids, thus amplifying cellular action. 11β-HSD1 is widely expressed in liver, adipose tissue, muscle, pancreatic islets, adult brain, inflammatory cells, and gonads. 11β-HSD1 is selectively elevated in adipose tissue in obesity where it contributes to metabolic complications. Similarly, 11β-HSD1 is elevated in the ageing brain where it exacerbates glucocorticoid-associated cognitive decline. Deficiency or selective inhibition of 11β-HSD1 improves multiple metabolic syndrome parameters in rodent models and human clinical trials and similarly improves cognitive function with ageing. The efficacy of inhibitors in human therapy remains unclear. 11β-HSD2 is a high-affinity dehydrogenase that inactivates glucocorticoids. In the distal nephron, 11β-HSD2 ensures that only aldosterone is an agonist at mineralocorticoid receptors (MR). 11β-HSD2 inhibition or genetic deficiency causes apparent mineralocorticoid excess and hypertension due to inappropriate glucocorticoid activation of renal MR. The placenta and fetus also highly express 11β-HSD2 which, by inactivating glucocorticoids, prevents premature maturation of fetal tissues and consequent developmental “programming.” The role of 11β-HSD2 as a marker of programming is being explored. The 11β-HSDs thus illuminate the emerging biology of intracrine control, afford important insights into human pathogenesis, and offer new tissue-restricted therapeutic avenues.

11β-Hydroxysteroid Dehydrogenases: Intracellular Gate-Keepers of Tissue Glucocorticoid Action

http://www.jbc.org/content/188/2/763.full.pdf

Paper chromatography of steroids. II. Corticosteroids and related compounds.

An Electronic Method of Tracing the Movements of Soil-inhabiting Insects: A. P. Arnason, R. A. Fuller, and J. W. T. Spinks ....................................................................... Adrenal Cortical Hormones: Analysis by Paper Partition Chromatography and Occurrence in the Urine of Normal Persons: Alejandro Zaffaroni, Robert B. Burton, and E. H enry K utmann ...........................................................

http://science.sciencemag.org/content/sci/111/2871/6.full.pdf

Adrenal Cortical Hormones: Analysis by Paper Partition Chromatography and Occurrence in the Urine of Normal Persons

The application of paper partition chromatography to steroid analysis: i. ketosteroids

https://acsjournals.onlinelibrary.wiley.com/doi/pdf/10.1002/1097-0142%28195105%294%3A3%3C500%3A%3AAID-CNCR2820040304%3E3.0.CO%3B2-P

E. Henry Keutmann

Papers

Paper chromatography of steroids. II. Corticosteroids and related compounds.

Adrenal Cortical Hormones: Analysis by Paper Partition Chromatography and Occurrence in the Urine of Normal Persons

The application of paper partition chromatography to steroid analysis: i. ketosteroids

Nitrogen exchange and caloric expenditure in patients with malignant neoplasms.

Corticosteroids in urine of normal persons determined by paper chromatography.