The multifactorial nature of osteoporosis: the potential of corticosteroid-binding globulin as a unifying regulator.

Accelerated bone loss often accompanies the menopause, and may also affect a significant proportion of ageing women. This osteoporosis can also be an accompaniment of several other pathological manifestations. It is difficult to imagine that each process alters bone resorption and renewal by a separate mechanism; in all probability a common mechanism may operate in some of the instances where osteoporosis is observed. It is proposed that chronic alterations in the levels of circulating physiologically-active cortisol could account for some of the osteoporoses. These alterations need not necessarily affect total plasma cortisol values, but rather affect the relationship of cortisol to its plasma carrier protein, transcortin, since changes in this relationship are a common occurrence in many of the conditions associated with osteoporosis.