Abstract:
OBJECTIVE:To examine the temporal and dose-related effects of glucocorticoids (GCs) on body mass index (BMI) in children with rheumatic diseases. METHODS:Children initiating GCs for a rheumatic disease (n = 130) were assessed every 3 months for 18 months. BMI, weight, and height Z score trajectories were described according to GC starting dosage in prednisone equivalents: high (≥1.0 mg/kg/day), low (<0.2 mg/kg/day to a maximum of 7.5 mg/day), and moderate (between high and low) dosage. The impact of GC dosing, underlying diagnosis, pubertal status, physical activity, and disease activity on BMI Z scores and on percent body fat was assessed with longitudinal mixed-effects growth curve models. RESULTS:The GC starting dose was high in 59% and moderate in 39% of patients. The peak BMI Z score was +1.29 at 4 months with high-dose GCs and +0.69 at 4.2 months with moderate-dose GCs (P < 0.001). Overall, 50% (95% confidence interval 41-59%) of the children returned to within +0.25 SD of their baseline BMI Z score. Oral GC dose over the preceding 3 months was the most significant determinant of BMI Z score and percent body fat. The proportion of days in receipt of GCs, disease activity, and a diagnosis of systemic-onset juvenile idiopathic arthritis were also associated with BMI Z scores. The correlation between changes in BMI and changes in percent body fat was 0.09. CONCLUSION:In children with rheumatic diseases starting moderate and high doses of GCs, BMI Z scores peaked at 4 months, and only half returned to within +0.25 SD of their baseline BMI Z score after 18 months.
journal_name
Arthritis Care Res (Hoboken)journal_title
Arthritis care & researchauthors
Shiff NJ,Brant R,Guzman J,Cabral DA,Huber AM,Miettunen P,Roth J,Scuccimarri R,Alos N,Atkinson SA,Collet JP,Couch R,Cummings EA,Dent PB,Ellsworth J,Hay J,Houghton K,Jurencak R,Lang B,Larche M,Leblanc C,Rodd C,Sdoi
10.1002/acr.21785subject
Has Abstractpub_date
2013-01-01 00:00:00pages
113-21issue
1eissn
2151-464Xissn
2151-4658journal_volume
65pub_type
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