AB0642 Glucocorticoid intake, hyperglycemia and osteoporosis in patients with autoimmune diseases

Abstract

BackgroundAutoimmune diseases (AID) are often treated with glucocorticoids. Glucocorticoids have a number of substantial side effects in human body, including hyperglycemia and osteoporosis.ObjectivesOur study was to investigate the use of glucocorticoid in patients with autoimmune diseases and its negative influence on blood glucose and osteoporosis in the patients who receiving glucocorticoid treatment.MethodsPatients with autoimmune diseases were enrolled from July to December in 2017 in rheumatology department of the Third Affiliated Hospital of Sun Yat-sen University. Demographic information, family history, past medical history, and clinical information were collected by two rheumatologists, including years of having glucocorticoids for treatment, largest dose of methylprednisolone, current dose of glucocorticoids. Blood glucose, glycosylated haemoglobin, and bone mineral density was required. The Statistical Package for Social Sciences (SPSS) software version 21 was used for all data management and analysis.ResultsOf all the 75 patients, 15 (20%) were male patients. 14.7% had primary education, while 26.6% received education in university. Numbers of the patients were stated as follows. Lupus, 29; rheumatoid arthritis, 4; Sjogren’s syndrome, 10; systemic sclerosis, 10; myositis, 4; mixed connective tissue disease, 1; autoimmune hepatitis, 1; vasculitis, 5; other diseases, 11. Mean age was 40.29±14.64 years. Mean disease duration was 4.74±6.62 years. 3 (4%) patients had family history of diabetes. 3 (4%) patients had past medical history of diabetes. Mean duration of taking glucocorticoids was 3.30±4.40 years. 13 (17.3%) of the patients underwent high dose of glucocorticoid intravenous pulse (120 mg to 1000 mg of methylprednisolone). Current dose of glucocorticoids was 5.30±3.96 tablets of methylprednisolone. Mean blood glucose was 4.61±0.92 mmol/L. Mean glycosylated haemoglobin was 5.46±0.84. 2 patients were found to have diabetes in this study. 5 other patients were found to have higher blood sugar than normal range (3.9–6.1 mmol/L, according to our laboratory). 14 (18.7%) of the patients had osteoporosis according to BMD scores. In 17 patients who had receiving glucocorticoids for more than five years, 3 (17.6%) patients were found to have higher blood sugar than normal range and 5 (29.4%) patients were found to have osteoporosis.ConclusionsGlucocorticoids have substantial side effects in hyperglycemia and osteoporosis in the patient receiving glucocorticoid treatment. More years of taking glucocorticoids could lead to more hyperglycemia and osteoporosis. We should evaluate side effects of glucocorticoids in the patients with AIDs.Disclosure of InterestY. Jiang: None declared, G. Du: None declared, X. Wu: None declared, Y. Xie: None declared, M. Zhao: None declared, Z. Liao Grant/research support from: National Natural Sciences Foundation of China [grant number 81201372], J. Gu Grant/research support from: the 5010 Subject of Sun Yat-sen University (2007023)