Changes in total body fat and body mass index among children with juvenile dermatomyositis treated with high-dose glucocorticoids.
Changes in total body fat and body mass index among children with juvenile dermatomyositis treated with high-dose glucocorticoids.
复制标题
接受高剂量糖皮质激素治疗的青少年皮肌炎患儿体内总脂肪和体重指数的变化
DOI：
10.1186/s12969-021-00622-1
复制
发表时间：
2021-08-10
期刊：
影响因子：
--
通讯作者：
Pachman LM
中科院分区：
文献类型：
--
作者：
Khojah A;Liu V;Morgan G;Shore RM;Pachman LM
高剂量糖皮质激素（GC）仍然是缓解幼年皮肌炎（JDM）的主要疗法。关于儿童 GC 相关体重增加的自然史的研究非常有限，尤其是在 JDM 人群中。本研究旨在测量一组 JDM 受试者在 60 个月内的 BMI 变化，并通过 DXA 检查身体成分的变化。我们纳入了所有具有 5 年随访数据和多项 DXA 研究的 JDM 受试者。 BMI 和全身脂肪 (TBF) 百分位数是根据 CDC 发布的百分位数图表计算的。为了研究体重增加和 TBF 的自然史，我们评估了四个时间点的数据（T0 = 基线、T1 > 1.5 年、T2 = 1.51–3.49 年、T3 = 3.5–5 年）。这项回顾性研究纳入了 68 名受试者（78% 女性，70% 白人）。配对 T 检验显示，开始药物治疗后，平均 BMI 百分位数显着增加了 17.5 个百分点 (P = 0.004)，随后在研究期间逐渐下降。然而，TBF 百分位在研究期间没有变化。上次就诊 (T3) 时的 TBF 与 T1 BMI 和 T1 TBF 百分位具有很强的相关性（相关系数分别为 0.63、0.56 P< 0.001、0.002）。此外，TBF 百分位与肌肉 DAS 之间存在正相关（相关系数为 0.39，P = 0.002），但与皮肤 DAS 之间不存在正相关。尽管 BMI 百分位数在整个研究过程中有所下降，但 TBF 百分位数直到研究结束（60 个月）仍保持较高水平。这一发现引发了人们的担忧，即 BMI 百分位数的部分降低可能反映了肌肉消耗导致的去脂体重下降，而不是实际的脂肪减少。在线版本包含可在 10.1186/s12969-021-00622-1 获取的补充材料。
High-dose glucocorticoids (GC) remain the primary therapy to induce remission in Juvenile Dermatomyositis (JDM). Studies of the natural history of GC associated weight gain in children are very limited, especially in the JDM population. This study aims to measure BMI changes in a cohort of JDM subjects over 60 months and to examine the changes in body composition by DXA. We included all subjects with JDM who had 5 years of follow-up data and multiple DXA studies. BMI and total body fat (TBF) percentiles were calculated based on the CDC published percentile charts. To study the natural history of weight gain and TBF, we assessed the data at four-time points (T0 = baseline, T1 > 1.5 years, T2 = 1.51–3.49 years, T3 = 3.5–5 years). 68 subjects (78% female, 70% white) were included in this retrospective study. Paired T-test showed a significant increase in the mean BMI percentile by 17.5 points (P = 0.004) after the initiation of medical treatment, followed by a gradual decrease over the study period. However, the TBF percentile did not change over the study period. TBF in the last visit (T3) had a strong correlation with the T1 BMI, and T1 TBF percentile (correlation coefficients 0.63, 0.56 P < 0.001, 0.002 respectively). Also, there was a positive correlation (correlation coefficients 0.39, P = 0.002) between the TBF percentile and muscle DAS but not the skin DAS. Although the BMI percentile decreased throughout the study, the TBF percentile remained high until the end of the study (60 months). This finding raises the concern that some of the reduction in the BMI percentile could reflect a drop in the lean body mass from muscle wasting rather than actual fat loss. The online version contains supplementary material available at 10.1186/s12969-021-00622-1.
登录
查看更多内容
影响因子：
1.4
作者：
Levin, Avi;Morad, Yair;Bar-Dayan, Yosefa
通讯作者：
Bar-Dayan, Yosefa
影响因子：
9.8
作者：
GOTFREDSEN, A;JENSEN, J;CHRISTIANSEN, C
通讯作者：
CHRISTIANSEN, C
DOI：
10.1186/s12950-015-0075-2
发表时间：
2015
期刊：
Journal of inflammation (London, England)
影响因子：
--
作者：
Olazagasti JM;Hein M;Crowson CS;de Padilla CL;Peterson E;Baechler EC;Reed AM
通讯作者：
Reed AM
影响因子：
1.2
作者：
Pachman LM;Nolan BE;DeRanieri D;Khojah AM
通讯作者：
Khojah AM
影响因子：
5.1
作者：
Pachman, LM;Abbott, K;Ramsey-Goldman, R
通讯作者：
Ramsey-Goldman, R