Prednisone affects inflammation, glucose tolerance, and bone turnover within hours of treatment in healthy individuals
Prednisone affects inflammation, glucose tolerance, and bone turnover within hours of treatment in healthy individuals
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DOI：
10.1530/eje-11-0751
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发表时间：
2012-03-01
影响因子：
5.8
通讯作者：
Ruddy, Marcella
中科院分区：
文献类型：
--
作者：
Kauh, Eunkyung;Mixson, Lori;Ruddy, Marcella
目的：糖皮质激素的抗炎疗效受到其副作用的限制。设计：在这项随机、双盲、平行设计的健康成人试验中，患者每天服用安慰剂或泼尼松10、25或60 mg，连续7天。方法：在强的松对外周血白细胞(WBC)计数、体外全血脂多糖(LPS)刺激的肿瘤坏死因子-α(TNF-α)释放以及皮肤变应原刺激的反应的影响的同时，评估了强的松对葡萄糖耐量和骨转换的生物标志物的影响。在体外，所有剂量的泼尼松在第1天和第7天均可显著降低脂多糖刺激的肿瘤坏死因子-α。在第1天和第7天，泼尼松60 mg与安慰剂相比，晚期皮肤变应原反应显著减少。口服葡萄糖耐量试验显示，第1天和第7天的血糖漂移显著增加，而所有剂量的泼尼松在第7天胰岛素和C肽漂移的增加更为显著。与安慰剂相比，骨形成标志物骨钙素、I型前胶原N端肽和C端肽在第1天和第7天显著下降。结论：在健康青年中，单次给药低至10 mg后，强的松治疗在治疗后的小时内对糖耐量和骨形成标志物有显著影响，同时具有抗炎作用。
Objective: Use of glucocorticoids for anti-inflammatory efficacy is limited by their side effects. This study examined, in the same individuals, prednisone's acute, dose-dependent effects on inflammation as well as biomarkers of glucose regulation and bone homeostasis.Design: In this randomized, double-blind, parallel-design trial of healthy adults demonstrating cutaneous allergen-induced hypersensitivity, patients received placebo or prednisone 10, 25 or 60 mg daily for 7 days.Methods: Effects on peripheral white blood cell (WBC) count, ex vivo whole blood lipopolysaccharide (LPS)-stimulated TNF-alpha release and response to cutaneous allergen challenge were assessed concurrently with biomarkers for glucose tolerance and bone turnover.Results: Differential peripheral WBC counts changed significantly within hours of prednisone administration. Ex vivo, LPS-stimulated TNF-alpha was significantly reduced by all prednisone doses on days 1 and 7. The late phase cutaneous allergen reaction was significantly reduced with prednisone 60 mg vs placebo on days 1 and 7. Oral glucose tolerance tests revealed significant increases in glycaemic excursion on days 1 and 7, whereas increases in insulin and C-peptide excursions were more notable on day 7 with all doses of prednisone. The bone formation markers osteocalcin, and procollagen I N- and C-terminal peptides decreased significantly on days 1 and 7 vs placebo.Conclusions: In healthy young adults after single doses as low as 10 mg, prednisone treatment has significant effects on glucose tolerance and bone formation markers within hours of treatment, in parallel with anti-inflammatory effects.