Corticosteroids kill osteoblasts. (1)
Killing osteoblasts accelerates the renewal of osteoblasts, and thus accelerates the aging of the capacity of osteoblasts to generate new bone matrix.
Cortisol is a corticosteroid produced and secreted in the body. It is a so-called 'stress hormone'.
Crohn's Disease comes with elevated cortisol levels (2), as this is a response to the continuous inflammatory processes in people with Crohn's Disease.
Crohn's Disease is associated with greatly increased vertebral fracture rates, even in young people. (3)
This is not due to increased breakdown of bone tissue (urine calcium excretion is lower!), but due to suppressed bone formation. (4)
This supports my theory that osteoporosis is caused by repeatedly inducing osteoblast cell death by any means, including a lifetime high calcium intake.
(1) Weinstein, RS, et al, Apoptosis of osteocytes in glucocorticoid-induced osteonecrosis of the hip. J. Clin. Endocrinol. Metab. 2000 / 85 (8) / 2907-2912. , Silvestrini, G, et al, Evaluation of apoptosis and the glucocorticoid receptor in the cartilage growth plate and metaphyseal bone cells of rats after high-dose treatment with corticosterone. Bone2000 / 26 (1) / 33-42. , Gohel A, et al, Estrogen prevents glucocorticoid-induced apoptosis in osteoblasts in vivo and in vitro. Endocrinology1999 / 140 (11) / 5339-5347.
(2) Straub RH, et al, Association of humoral markers of inflammation and dehydroepiandrosterone sulfate or cortisol serum levels in patients with chronic inflammatory bowel disease. Am J Gastroenterol 1998 Nov;93(11):2197-202.
(3) Klaus J, et al, High prevalence of osteoporotic vertebral fractures in patients with Crohn's disease. Gut 2002 Nov;51(5):654-8.
Schoon EJ, et al, Abnormal bone turnover in long-standing Crohn's disease in remission. Aliment Pharmacol Ther 2001 Jun;15(6):783-92.
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