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Cited by 59HIV-related health complications and treatmentsAdrenal Hormones and DisordersDiabetes, Cardiovascular Risks, and Lipoproteins

Corticosteroid-induced lipodystrophy is associated with features of the metabolic syndrome

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Fardet, L., Cabane, J., Kettaneh, A., Lebbe, C., Flahault, A.·2007·Rheumatology
DOI 10.1093/rheumatology/kem062
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Abstract

OBJECTIVE: Familial and HIV-associated lipodystrophies are associated with metabolic disorders and elevated blood pressure. Whether corticosteroid-induced lipodystrophy (CIL) is also associated with features of the metabolic syndrome is unknown. METHODS: We conducted a prospective study in two French tertiary centres and enrolled all consecutive patients starting long-term (> or = 3 months), high dosage (> or = 20 mg/day) systemic corticosteroid therapy. Three investigators assessed the development of CIL from standardized head and neck photographs. Arterial blood pressure and fasting blood glucose levels were assessed at baseline and then every three months until month 12. Total, HDL- and LDL-cholesterol and triglycerides were recorded at baseline, month 3 and month 12. RESULTS: Eighty-eight patients were enrolled (women: 75%, mean age: 57.4 +/- 17.9 yrs, mean baseline dosage of prednisolone: 56 +/- 15 mg/day). Sixty-four patients still received corticosteroids at month 12 (mean prednisolone dosage: 11 +/- 4 mg/day). In intention-to-treat analysis, the cumulative incidence rate of CIL at months 3 and 12 was 61 +/- 8% and 69 +/- 9%, respectively. Baseline characteristics were similar in patients who developed CIL and patients who did not develop CIL during follow-up except with regard to baseline body mass index, which was higher in patients who develop CIL (24.3 +/- 3.7 kg/m2 vs 21.4 +/- 3.2 kg/m2, P= 0.02). Blood pressure was significantly higher in CIL+ patients at month 9 (135/78 mmHg vs 127/73 mmHg) and month 12 (141/81 mmHg vs 128/72 mmHg) visits. Moreover, compared with CIL- patients, CIL+ patients had significantly higher plasma concentrations of fasting blood glucose, triglycerides and total cholesterol and lower HDL-cholesterol concentration during follow-up. CONCLUSIONS: CIL is associated with features of the metabolic syndrome and should then not be considered only as an aesthetic challenge. Further studies are required to test the relation between CIL and cardiovascular events.

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  • A controlled trial in 23 women with BMI >25 kg/m2 and mild, stable systemic lupus erythematosus receiving low-dose prednisolone over six weeks indicated that significant weight loss (mean 3 kg) and fatigue improvement could be similarly achieved with either a standard diet or a low glycemic diet.

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  • In the same trial, both the standard diet and the low glycemic diet were equally tolerable and did not cause flares in disease activity.

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    From ESPEN guideline on hospital nutrition (2021) · cites this paper as [162]

    The Participants and Study design and data collection sections describe follow-up of patients receiving corticosteroids, not a comparison of standard and low-glycemic diets. Searches for the diets, tolerability, and disease flares found no passage in our copy addressing the claim. Page numbers were not available for these passages. (LLM, conf=0.78)

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Authors
Fardet, L., Cabane, J., Kettaneh, A., Lebbe, C., & Flahault, A.
Affiliations
Inserm (FR)
ORCID
Venue
Rheumatology
Publisher
Oxford University Press (OUP)
Published
2007-05-09
Volume
46
Issue
7
Pages
1102-1106
ISSN
  • 1462-0324 (ISSN-L)
  • 1462-0332
DOI
10.1093/rheumatology/kem062
OpenAlex
W2111366717
Cited by
59
References
3
Citations by year
2025: 1 · 2024: 2 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 2 · 2017: 5 · 2016: 1 · 2015: 7 · 2014: 3 · 2013: 5 · 2012: 10
FWCI
5.75
Type
journal article
Language
en
Open access
Locations
  • Lara D. Veeken (publishedVersion)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
Topics
  • Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
metabolic syndrome, systemic corticosteroid therapy, prednisolone, arterial blood pressure, fasting blood glucose, triglycerides, cholesterol, HDL cholesterol, body mass index, cardiovascular risk
MeSH terms
Adrenal Cortex Hormones, Adult, Aged, Blood Glucose, C-Reactive Protein, Cholesterol, Female, Humans, Hypertension, Immunosuppressive Agents, Lipodystrophy, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Prospective Studies, Triglycerides, Chi-Square Distribution, Statistics, Nonparametric, Metabolic Syndrome

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