Corticosteroid use associated with metabolic syndrome in women

ORLANDO, Fla. — Women prescribed systemic or local corticosteroids are more likely to develop metabolic syndrome compared with women who are nonusers, according to study results presented here.

Discussing the findings during a press conference, Mesut Savas, MD, MSc, a research physician and PhD student at Erasmus MC, University Medical Center in Rotterdam, Netherlands, said inhaled corticosteroids primarily drove the association with increased metabolic syndrome risk, and these agents are also associated with increased BMI in both men and women.

Mesut Savas

“At the moment, it’s unclear why there is a difference [between men and women],” Savas told Endocrine Today. “One of the [reasons] could be that women are more adherent to their medication use. Another explanation could be a difference in the body fat between men and women ... men are more likely to have fat around the waist, which is an important inducer of metabolic changes. Corticosteroids do increase your body fat, so it could be that the differences are less profound in men.”

Savas and colleagues analyzed data from 140,879 adults from the Dutch general population who participated in the Lifelines Study Cohort (mean age, 45 years; 58.5% women). All participants completed questionnaires on drug use and provided medications for a site inspection during a study visit; drugs were coded according to the WHO ATC classification system. Researchers assessed BMI, waist circumference, systolic and diastolic blood pressure, and fasting serum levels of triglycerides, HDL cholesterol and glucose for all participants.

Within the cohort, 10.9% were currently prescribed corticosteroids; most were local administration forms (95.4%).

Researchers found that, compared with nonusers, those who were prescribed corticosteroids had higher odds of having metabolic syndrome (OR = 1.11; 95% CI, 1.06-1.18) and a higher BMI (mean, 0.31 kg/m²). However, in sex-stratified analyses, the association was markedly higher in women (OR = 1.21; 95% CI, 1.12-1.31) vs. men (OR = 0.98; 95% CI, 0.9-1.06). Women prescribed corticosteroids also experienced greater mean gains in BMI vs. men (mean BMI increase, 0.43 kg/m² vs. 0.04 kg/m²).

“We found striking differences in relationships with corticosteroids and metabolic syndrome for men and women,” Savas said.

Results persisted for both types of corticosteroid administration, Savas said, with users of both systemic and local forms experiencing increased BMI and risk for metabolic syndrome. However, among users of local corticosteroids, inhaled corticosteroids drove the association, Savas said; participants prescribed inhaled corticosteroids had a higher likelihood for metabolic syndrome vs. nonusers (OR = 1.23; 95% CI, 1.13-1.34) and a higher mean BMI (0.65 kg/m²).

“We found that the use of local corticosteroids, especially inhaled forms, might be a substantial risk for increased BMI and metabolic syndrome,” Savas said. – by Regina Schaffer

Reference:

Savas M, et al. OR03-2. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2017; Orlando, Fla.

Disclosure: Savas reports no relevant financial disclosures.