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Journal of the American Academy of Dermatology
Volume 57, n° 4
pages 604-609 (octobre 2007)
Doi : 10.1016/j.jaad.2007.04.018
accepted : 23 April 2007
Reports

Incidence and risk factors for corticosteroid-induced lipodystrophy: A prospective study
 

Laurence Fardet, MD a, b, , Jean Cabane, MD a, Céleste Lebbé, MD, PhD c, Patrice Morel, MD c, Antoine Flahault, MD, PhD b
a Department of Internal Medicine, Hôpital Saint-Antoine, Paris, France 
b Department of Public Health, Hôpital Tenon, Paris, France 
c Department of Dermatology, Hôpital Saint-Louis, Paris, France 

Reprint requests: Laurence Fardet, MD, Department of Internal Medicine, Hôpital Saint-Antoine, 184 rue du faubourg Saint-Antoine, 75012 Paris, France.
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.

The full text of this article is available in PDF format.

 Funding sources: None.
 Conflicts of interest: None declared.



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