Corticosteroid-induced hyperglycemia is increased 10-fold in patients with pemphigus
Corticosteroid-induced hyperglycemia is increased 10-fold in patients with pemphigus
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DOI：
10.1111/j.1365-4632.2012.05470.x
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发表时间：
2012-10-01
影响因子：
3.6
通讯作者：
Shear, Neil H.
中科院分区：
文献类型：
--
作者：
Alavi, Afsaneh;Lowe, Julia;Shear, Neil H.
这项研究旨在强调常规筛查高血糖的重要性，并开发一种标准化的循证方法来管理接受长期全身皮质类固醇(CS)治疗的天疱疮患者。在两所大学附属的教学医院进行了一项横断面研究，使用了200名确诊为寻常型天疱疮、叶型天疱疮或粘膜类天疱疮的患者的参考样本。所有患者均接受全身CS治疗。共有150名患者对调查做出了回应。6名参与者被排除在外，144名被纳入。主要观察指标为检测高血糖的血糖水平。接受CS治疗的患者中有40%新发高血糖。没有一个预期变量，包括年龄、体重指数、糖尿病家族史、皮质类固醇剂量和皮质类固醇治疗持续时间，与新发高血糖独立相关。这些发现表明，在天疱疮患者中，CS引起的高血糖的发生率为40%，与没有接受CS治疗的相同疾病的患者相比，CS治疗与患高血糖的风险显著增加相关(优势比=10.7，95%可信区间1.3883.50)。
This study aimed to highlight the importance of routine screening for hyperglycemia and to develop a standardized, evidence-based approach for the management of pemphigus patients on prolonged systemic corticosteroid (CS) therapy. A cross-sectional study was conducted in two university-affiliated teaching hospitals using a referred sample of 200 patients with a confirmed diagnosis of pemphigus vulgaris, pemphigus foliaceus, or mucous membrane pemphigoid. All patients were receiving systemic CS therapy. A total of 150 patients responded to the survey. Six participants were excluded and 144 were included. The main outcome measure was blood glucose level to detect hyperglycemia. New-onset hyperglycemia was identified in 40% of patients who received CS therapy. None of the expected variables, including age, body mass index, family history of diabetes, corticosteroid dose, and duration of corticosteroid therapy, were independently associated with new-onset hyperglycemia. These findings indicate that the prevalence of CS-induced hyperglycemia in pemphigus patients is 40% and that in patients with pemphigus or MMP, CS therapy is associated with a markedly increased risk for hyperglycemia (odds ratio = 10.7, 95% confidence interval 1.3883.50) compared with that of patients with the same diseases who do not receive CS therapy.