Incidence and risk factors for corticosteroid-induced lipodystrophy: A prospective study - 19/08/11
Abstract |
Background |
Very few studies have focused on fat redistribution induced by corticosteroids.
Objective |
To establish the incidence and risk factors of facial (“moon face”) and cervical (“buffalo hump”) lipodystrophy due to long-term (≥3 months), high dosage (≥20 mg/d) systemic corticosteroid therapy.
Methods |
Between June 2003 and May 2005 we conducted a prospective study in two French tertiary centers. All consecutive patients starting long-term systemic corticosteroid therapy at an initial daily dosage of 20 mg or more were enrolled in this study. Three investigators assessed the development of facial and cervical corticosteroid-induced lipodystrophy (CIL) from standardized photographs. Demographic, clinical, and nutritional data were examined to assess risk factors of CIL.
Results |
Eighty-eight patients were enrolled (women: 75%, mean age: 57.4 ± 17.9 years, mean baseline dosage of prednisone: 56 ± 15 mg/d). The cumulative incidence rate of CIL at months 3 and 12 was 61% ± 8% and 69% ± 9%, respectively. In multivariate analyses the risk of CIL at the third month was higher in women (odds ratio [OR]: 10.87 [2.43-58.82]), in subjects younger than 50 years of age (OR: 11.11 [2.19-37.89]), in subjects with a high initial body mass index (OR: 1.56 [1.21-2.03] per increment of 1 kg/m2) and in subjects with high energy intake (OR: 6.11 [1.35-27.75] when higher than 30 kcal/d/kg).
Limitations |
Photographic analysis is not a conventional method for the diagnosis of CIL.
Conclusion |
CIL frequently occurs, especially in overweight subjects and in women, who are also at higher risk to develop other forms of lipodystrophies.
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Funding sources: None. |
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Conflicts of interest: None declared. |
Vol 57 - N° 4
P. 604-609 - octobre 2007 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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