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Petar Milovanovic Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Laboratory for Anthropology and Skeletal Biology, Institute of Anatomy, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

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Björn Busse Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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osteocyte death also occurs due to hormonal reasons, such as estrogen deficiency or corticosteroid excess ( 38 , 39 , 45 ). Moreover, osteocyte death may be caused by mechanical factors ( 36 , 46 ), but the relationship between mechanical loading and

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Trevor Lewis Physiotherapy Department, Aintree University Hospital NHS Foundation Trust, Liverpool, UK

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Eva Zeisig Department of Surgical and Perioperative Sciences, Umeå Univerisity, Umeå, Sweden

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Jamie E Gaida University of Canberra Research Institute for Sport and Exercise (UCRISE), Canberra, Australian Capital Territory, Australia

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and associated metabolic conditions, such as insulin resistance ( 5 ), diabetes ( 6 ), hypercholesterolaemia ( 7 ), statins ( 8 ), abdominal fat ( 9 ), the sympathetic nervous system ( 10 , 11 ), and corticosteroid use ( 12 ). Glucocorticoids are a

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Angelica Sharma Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Katharine Lazarus Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Deborah Papadopoulou Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Hemanth Prabhudev Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Tricia Tan Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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Karim Meeran Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK

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Sirazum Choudhury Division of Diabetes, Endocrinology and Metabolism, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
Department of Clinical Biochemistry, North West London Pathology, London, UK

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equivalent to a prednisolone dose of 2–4 mg once daily. This may be because prednisolone has half the affinity for corticosteroid-binding globulin as compared to cortisol, and therefore higher concentrations of unbound prednisolone are present ( 10

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Kamran Iqbal Shire, London, UK

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Kate Halsby pH Associates, Marlow, UK

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Robert D Murray Leeds Centre for Diabetes & Endocrinology, St James’s University Hospital, Leeds, UK

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Paul V Carroll Department of Endocrinology, Guy’s & St. Thomas’ NHS Foundation Trust, London, UK

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Robert Petermann Shire, Vienna, Austria

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information is well recorded and accurate ( 13 , 14 ). Study population The population of interest comprised patients with treated AI defined as an AI-specific Read code and at least one Multilex code for the corticosteroids of interest (i.e. IR HC

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Stephanie E Baldeweg Department of Endocrinology, University College Hospital, London, UK
National Hospital for Neurology and Neurosurgery, London, UK

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Mark Vanderpump Physicians’ Clinic, London, UK

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Will Drake Department of Endocrinology, St Bartholomew’s Hospital, London, UK

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Narendra Reddy Endocrinology/General Medicine, University Hospitals Coventry and Warwickshire NHS Trust, University of Warwick, Coventry, UK

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Andrew Markey The Lister Hospital, London, UK

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Gordon T Plant Department of Endocrinology, University College Hospital, London, UK
National Hospital for Neurology and Neurosurgery, London, UK

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Michael Powell National Hospital for Neurology and Neurosurgery, London, UK

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Saurabh Sinha Royal Hallamshire Hospital, Sheffield, UK

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John Wass Department of Endocrinology, Oxford Centre for Diabetes Endocrinology and Metabolism, The Churchill, Oxford University, Oxford, UK

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the Society for Endocrinology Clinical Committee The Society for Endocrinology, 22 Apex Court, Woodlands, Bradley Stoke, Bristol, UK

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emergencies. Prompt resuscitation and corticosteroid replacement may be lifesaving. MRI scan is the investigation of choice. Urgent discussion with the regional neurosurgical/endocrine team is essential. Surgical intervention should be considered in

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Marcus Quinkler Endocrinology in Charlottenburg, Berlin, Germany

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Bertil Ekman Departments of Endocrinology and Medical and Health Sciences, Linköping University, Linköping, Sweden

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Claudio Marelli Shire International GmbH, Zug, Switzerland

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Sharif Uddin Shire, Lexington, Massachusetts, USA

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Pierre Zelissen Department of Internal Medicine and Endocrinology, University Medical Center Utrecht, Utrecht, the Netherlands

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Robert D Murray Department of Endocrinology, Leeds Teaching Hospitals NHS Trust, St James’s University Hospital, Leeds, UK

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on behalf of the EU-AIR Investigators
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development of corticosteroid side effects between patients ( 7 ). Interestingly, when the endogenous glucocorticoid, cortisol (hydrocortisone), is compared with prednisolone at the isolated human glucocorticoid receptor (GR), the transactivation activity of

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Greta B Raglan Department of Psychology, American University, Washington, District of Columbia, USA

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Louis A Schmidt Department of Psychology, Neuroscience & Behavior, McMaster University, Hamilton, Ontario, Canada

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Jay Schulkin Department of Research, American College of Obstetricians and Gynecologists, Washington, District of Columbia, USA
Department of Neuroscience, Georgetown University, Washington, District of Columbia, USA

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as a possible intervention for mental illness including depression. Although further study is necessary, it appears that corticosteroid synthesis inhibitors (CSIs) may show some efficacy in treating individuals with intractable depression ( 23

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Theodoros Karampitsakos Third Department of Obstetrics and Gynecology, ATTIKON University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Fotini Kanouta Unit of Endocrinology, Diabetes Mellitus and Metabolism, First Department of Obstetrics and Gynecology, ALEXANDRA University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Christos Chatzakis Second Department of Obstetrics and Gynecology, IPPOKRATEIO General Hospital of Thessaloniki, Aristotle, University of Thessaloniki, Athens, Greece

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Vassilios Bakoulas Athens, Greece

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Alexandros Gryparis Department of Speech and Language Therapy, University of Ioannina, Ioannina, Greece
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Petros Drakakis Third Department of Obstetrics and Gynecology, ATTIKON University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Djuro Macut Department of Endocrinology, Diabetes and Diseases of Metabolism, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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George Mastorakos Unit of Endocrinology, Diabetes Mellitus and Metabolism, ARETAIEION University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

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Courses of Antenatal Corticosteroids for Preterm Birth Study), studied 935 (index group) compared to 918 (control group) pregnant women ( 22 ). The aim of the study was to estimate the effect of multiple courses of antenatal sGCs (betamethasone or

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Martijn J J Finken Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

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Aleid J G Wirix Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

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Ines A von Rosenstiel-Jadoul Department of Pediatrics, Rijnstate Hospital, Arnhem, The Netherlands

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Bibian van der Voorn Department of Pediatric Endocrinology and Obesity Center CGG, Erasmus MC Sophia Children’s Hospital, Rotterdam, The Netherlands

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Mai J M Chinapaw Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

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Michaela F Hartmann Steroid Research and Mass Spectrometry Unit, Laboratory for Translational Hormone Analytics, Department of Pediatric Endocrinology & Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany

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Joana E Kist-van Holthe Department of Public and Occupational Health, EMGO Institute for Health and Care Research, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

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Stefan A Wudy Steroid Research and Mass Spectrometry Unit, Laboratory for Translational Hormone Analytics, Department of Pediatric Endocrinology & Diabetology, Center of Child and Adolescent Medicine, Justus Liebig University, Giessen, Germany

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Joost Rotteveel Department of Pediatric Endocrinology, Emma Children’s Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands

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, raised blood pressure, insulin resistance, and dyslipidemia ( 7 , 10 ). There is controversy as to whether increased HPA axis activity is a cause or a consequence of childhood obesity. It has been demonstrated that the rise in serum corticosteroids

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Bliss Anderson Department of Endocrinology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK

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Daniel L Morganstein Department of Endocrinology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK

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practice is to reserve high dose corticosteroids for those presenting with adrenal crisis or with significant pituitary enlargement. Other patients can be commenced directly on replacement doses of corticosteroids (e.g. hydrocortisone 20 mg daily in divided

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