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Corticosteroid use increases metabolic syndrome risk in women
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Local corticosteroid use is associated with more adverse cardiometabolic traits, especially the inhaled administration forms, with the risk being most pronounced for women, study data show.
Elisabeth F.C. van Rossum, MD, PhD, professor of medicine at Erasmus MC, University Medical Center in Rotterdam, the Netherlands, and colleagues evaluated data from the Lifelines Cohort Study on 140,879 adults (58.5% women) to determine the association between overall corticosteroid use and specific corticosteroid types with metabolic syndrome, BMI and other cardiometabolic traits.
Overall, 10.9% of participants were using any form of corticosteroids. The use was predominately local administration and single-type users and the most prescribed corticosteroids in both single- and multiple-type users were inhaled, nasal and topical agents.
The risk for metabolic syndrome was higher among women who used corticosteroids overall, locally and systemically compared with nonusers. Among women using local corticosteroids, the risk was highest with using nasal (OR = 1.2; 95% CI, 1.06-1.36) or inhaled corticosteroids (OR = 1.35; 95% CI, 1.24-1.49). No association was observed among men between corticosteroid use and metabolic syndrome.
Among women, BMI, waist circumference, systolic blood pressure and triglycerides were higher in corticosteroid users compared with nonusers. Local corticosteroid use was associated with higher fasting serum glucose levels and systemic corticosteroid use was associated with increased HDL cholesterol and decreased fasting serum glucose.
Local corticosteroid use in men was associated with a higher waist circumference and diastolic BP, whereas systemic corticosteroid use was associated with higher HDL cholesterol and lower fasting serum glucose.
“Use of local [corticosteroids], particularly inhaled types, as well as systemic [corticosteroids] was associated with higher likelihood of having [metabolic syndrome], higher BMI, and other adverse cardiometabolic traits, especially among women,” the researchers wrote. “Since the inhaled [corticosteroids] are the main group of prescribed [corticosteroids] this might be a substantial risk to public health. Further studies are needed to confirm these findings and evaluate the direction of causality and mechanisms behind these associations.” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.
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