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Cited by 58Adrenal Hormones and DisordersAdipokines, Inflammation, and Metabolic DiseasesHormonal and reproductive studies

Associations Between Systemic and Local Corticosteroid Use With Metabolic Syndrome and Body Mass Index

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Savas, Mesut, Muka, Taulant, Wester, Vincent L, van den Akker, Erica L T, Visser, Jenny A, Braunstahl, Gert-Jan, Slagter, Sandra N, Wolffenbuttel, Bruce H R +2 more·2017·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2017-01133
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Abstract

Context: Use of systemic corticosteroids (CSs) may induce adverse cardiometabolic alterations, potentially leading to obesity and metabolic syndrome (MetS). Although evidence is accumulating that local CSs have considerable systemic effects, their effects on cardiometabolic factors in the general population remain unclear. Objective: To investigate the association between overall CS use and specific CS types with MetS, body mass index (BMI), and other cardiometabolic traits. Design: Cross-sectional cohort study. Setting: General population from the northern Netherlands. Participants: A total of 140,879 adult participants in the population-based Lifelines Cohort Study. Main Outcome Measures: BMI, waist circumference, systolic and diastolic blood pressure, fasting metabolic serum parameters, and a comprehensive set of potential confounding factors. Results: In women, overall, systemic, and local CS use was associated with higher odds of having MetS. Among local female users, only nasal (odds ratio [OR], 1.20 [95% confidence interval (CI), 1.06 to 1.36]) and inhaled CSs [OR, 1.35 (95% CI, 1.24 to 1.49)] users were more likely to have MetS. In men, no association was found between overall and specific CS use and presence of MetS. Use of local-only CSs in women, specifically inhaled CSs in both sexes, was associated with higher BMI. Conclusions: Use of local CSs, particularly inhaled types, as well as systemic CSs, was associated with higher likelihood of having MetS, higher BMI, and other adverse cardiometabolic traits, especially among women. Because the inhaled agents are the main group of prescribed CSs, this might be a substantial risk to public health in case of a yet-to-be-proven causal relationship.

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  • These relations between corticosteroid use and cardiometabolic sequelae seemed to be related to glucocorticoid receptor gene variants associated with increased or normal glucocorticoid sensitivity.

    “These relations between corticosteroid use and cardiometabolic sequelae seemed to be related to glucocorticoid receptor gene variants that are associated with increased or normal glucocorticoid sensitivity.”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [37]

  • Use of local corticosteroids, particularly inhaled types, is associated with higher likelihood of metabolic syndrome, higher body mass index, reduced executive cognitive functioning, and higher likelihood of mood and anxiety disorders.

    “In this light, it is of interest that we recently showed associations between use of local corticosteroids, particularly inhaled types, and higher likelihood of metabolic syndrome, higher body mass index, reduced executive cognitive functioning, and a higher likelihood of mood and anxiety disorders (37, 38).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [37]

  • The vast majority of corticosteroid use involves local types.

    “Despite the lower probability of systemic adverse events in locally administered use, it is still of great importance given the fact that the vast majority of corticosteroid use involves the local types (37).”

    From Approach to the Patient: Diagnosis of Cushing Syndrome (2022) · cites this paper as [37]

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Authors
Savas, M., Muka, T., Wester, V. L., van den Akker, E. L. T., Visser, J. A., Braunstahl, G.-J., Slagter, S. N., Wolffenbuttel, B. H. R., Franco, O. H., & van Rossum, E. F. C.
Affiliations
  • Erasmus MC (NL)
  • University Medical Center Groningen (NL)
ORCID
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2017-08-02
Volume
102
Issue
10
Pages
3765-3774
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2017-01133
OpenAlex
W2739676848
Cited by
58
References
45
Citations by year
2026: 7 · 2025: 5 · 2024: 18 · 2023: 3 · 2022: 6 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 5
FWCI
2.81
Type
journal article
Language
en
Open access
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
corticosteroid use, systemic corticosteroids, local corticosteroids, inhaled corticosteroids, intranasal corticosteroids, metabolic syndrome, body mass index, obesity, cardiometabolic risk, sex differences, blood pressure, waist circumference, Lifelines cohort
MeSH terms
Adult, Cross-Sectional Studies, Drug Administration Routes, Female, Glucocorticoids, Humans, Male, Middle Aged, Netherlands, Obesity, Risk Factors, Cohort Studies, Body Mass Index, Metabolic Syndrome, Waist Circumference

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