ECE2022 Poster Presentations Diabetes, Obesity, Metabolism and Nutrition (202 abstracts)
The effects of Long-term (five years) prednisone therapy in frequently relapsing nephrotic syndrome of childhood: impact on glycemia and the different components of the metabolic syndrome (MetS)
Mostafa Elbaba 1 , Noor Hamed 1 , Ashraf Soliman 1 , Fawzia Alyafei 1 , Maya Itani 1,2 , Fatima Al-Naimi 1,2 , Doaa Al Yousef 2 & Mona Shaat Dalees 2
1Hamad Medical Center, Pediatrics, Doha, Qatar; 2Hamad Medical Center, Nutrition and Dietitic Department, Doha, Qatar
Although widely prescribed for their anti-inflammatory and immunosuppressive properties, glucocorticoids have various common metabolic side effects including hypertension, dysglycemia and diabetes.
Aim: This study was carried out to investigate the prevalence of different metabolic components and dysglycemia in children with steroid sensitive nephrotic syndrome (SSNS) with multiple relapses for 5 years in relation to the cumulative dose of steroids.
Methods: Data of 30 children with SSNS was analysed retrospectively. They received prednisolone only in the standard dose for the initial episode at 2 mg/kg/day for six weeks followed by 1.5 mg/kg on alternate days for six weeks and relapses were treated with 2 mg/kg/day till remission followed by 1.5 mg/kg/day for four weeks. The cumulative dose of steroids over the period of 5 years was calculated for each child. The growth data was recorded along the treatment period. The different metabolic criteria including impaired fasting glucose (IFG), high LDL and cholesterol, lower HD and high blood pressure for age and sex were studied over this period of time.
Results: The mean cumulative prednisone=125+/- 28 mg /kg/year given over an average duration of 5 years. Obesity (OB) and overweight (OW) increased from 25% pre-treatment to 59.2% after 5 years of treatment. After 3 and 5 years of treatment IFG was found in 24 and 36 % respectively, high LDL in 89% and 80% respectively, high cholesterol in 85% and 100% respectively. Hypertension was detected in 12.5% and 23% of patients after 3 and 5 years of treatment. The mean serum cholesterol and LDL levels were significantly higher than normal in treated children after 3 and 5 years of treatment.
| Variables | Beginning | 3 yr | 5 yr | P value |
| Number | 30 | 30 | 30 | |
| IFG (FBG >5.6 mmol/l | 15.93% | 24.14% | 35.71% | 0.1 |
| LDL > 2.7 mmol/l | 88.89% | 88.89% | 80.00% | 0.35 |
| HDL < 1.03 mmol/l | 10.53% | 10.00% | 0.00% | 0.07 |
| TG >1.7 mmol/l | 77.27% | 33.33% | 60.00% | 0.23 |
| Cholesterol > 4.5 mmol/l | 100.00% | 85.71% | 100.00% | 1 |
| Hypertension BP >95th centile for age | 23.30% | 12.50% | 23.00% | 0.9 |
Conclusion: Long term prednisone therapy (for 5 years) with a mean cumulative dose of prednisone=125 +/- 28 mg/kg/yr. was associated with increased prevalence of OW and obesity as well as with higher risk of developing hypertension and dyslipidemia.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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