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The pathophysiology of the effect of GC excess on bone often leads to fractures despite normal or low-normal bone mineral density and it includes direct (mainly disturbance in bone formation processes, through inactivation of the Wnt\/\u03b2-catenin signalling pathway) and indirect mechanisms (through suppressing the gonadal and somatotrophic axis,  and also through antagonizing vitamin D actions). Glucocorticosteroid-induced fast-twitch, glycolytic muscles atrophy occurs due to increased protein catabolism and impaired synthesis. Protein degradation is a result of activation of the ubiquitin proteasome and the lysosomes stimulated through overexpression of several atrogenes (such as FOXO-1 and atrogin-1).\nThis review will discuss pathophysiology, clinical presentation, prevention, and management of GC-\ninduced osteoporosis (including calcium and vitamin D supplementation, and bisphosphonates) and myopathy associated with GC excess.<\/jats:p>","DOI":"10.5114\/reum\/169889","type":"journal-article","created":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T02:43:11Z","timestamp":1693795391000},"page":"271-282","source":"Crossref","is-referenced-by-count":20,"title":["Musculoskeletal complications of Cushing syndrome"],"prefix":"10.5114","volume":"61","author":[{"given":"Dorota","family":"Leszczy\u0144ska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0297-7344","authenticated-orcid":false,"given":"Alicja","family":"Szatko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucyna","family":"Papierska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Zgliczy\u0144ski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1685-8541","authenticated-orcid":false,"given":"Piotr","family":"Glinicki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3061","published-online":{"date-parts":[[2023,8,31]]},"reference":[{"key":"ref-935217","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2021"},{"key":"ref-935218","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2011.04124.x"},{"key":"ref-935219","doi-asserted-by":"publisher","DOI":"10.1111\/cen.14014"},{"key":"ref-935220","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgz136"},{"key":"ref-935221","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(16)00086-3"},{"key":"ref-935222","doi-asserted-by":"publisher","DOI":"10.3803\/EnM.2021.1069"},{"key":"ref-935223","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2002.tb04204.x"},{"key":"ref-935224","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21796"},{"key":"ref-935225","doi-asserted-by":"publisher","DOI":"10.1002\/art.40137"},{"key":"ref-935226","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/39.12.1383"},{"key":"ref-935227","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2005-0582"},{"key":"ref-935228","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-004-1616-3"},{"key":"ref-935229","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.50.1"},{"key":"ref-935230","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021518"},{"key":"ref-935231","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3582"},{"key":"ref-935232","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-119-10-199311150-00001"},{"key":"ref-935233","doi-asserted-by":"publisher","DOI":"10.1210\/er.2018-00005"},{"key":"ref-935234","doi-asserted-by":"crossref","unstructured":"Ito S, Suzuki N, Kato S, et al. 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