Prospective short-term effects of glucocorticoid treatment on glucose and lipid metabolism in Japanese.

Objective: Glucocorticoid (GC) causes various metabolic abnormalities; however, few prospective studies have examined the changes in glucose and lipid metabolism in newly GC-treated patients.

Methods And Patients: The present study was therefore performed to analyze markers of glucose and lipid metabolism on days 0, 3, 7, 14, 28 and at month 3 of treatment in patients starting GC therapy. Then, we analyzed the relationships between the changes in these parameters and the initial dose of prednisolone (PSL), separating groups into different regimens by the GC dose.

Results: The fasting plasma glucose (FPG) level transiently increased on day 3 of PSL administration but was restored by day 7. The immunoreactive insulin (IRI) level and HOMA-R transiently increased on day 3 and then fell, although remaining significantly higher than each basal level by day 7. A transient elevation in FPG level on day 3 was observed only in groups with a PSL dose >or=40 mg. On the other hand, total cholesterol and low-density lipoprotein cholesterol levels increased on day 3 of PSL administration and similar levels were maintained after day 7. High density-lipoprotein cholesterol levels were significantly increased on day 3; subsequently then gradually increased from days 3 to day 28. Triglyceride levels did not change during treatment. No relationship was apparent between the GC dose and the changes in each lipid parameter.

Conclusion: GC treatment induced changes in FPG, IRI, LDL-CHOL and HDL-CHOL levels from day 3 after start of GC. The dose of GC seemed to influence glucose metabolism, but not lipid metabolism.