Hyperlipidaemia in Asthmatic Patients Receiving Long-term Steroid Therapy

El-Shaboury, A. H.; Hayes, T M

doi:10.1136/bmj.2.5858.85

Cited by 77 publications

(20 citation statements)

References 12 publications

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“…More generally, elevated levels of cortisol (whatever the source) have been found to be associated with greater atherosclerosis (6,8) as well as increases in cholesterol levels and diabetes (8,197,198), all phenomenon known to be more prevalent at older ages (199,200). Presence of diabetes, in fact, has often been characterized as a form of accelerated aging (201,202) with its increased risks for early onset of other conditions commonly associated with older age such as hypertension, bone diseases, cataracts (53), and cognitive impairment (201).…”

Section: Health Consequences Of Elevated Gcs In Humansmentioning

confidence: 98%

Aging and Hypothalamic-Pituitary-Adrenal Response to Challenge in Humans*

1994

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Section: Health Consequences Of Elevated Gcs In Humansmentioning

confidence: 98%

Aging and Hypothalamic-Pituitary-Adrenal Response to Challenge in Humans*

1994

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“…El-Shaboury and Hayes (1973) showed that both triglycerides and cholesterol were increased in 100 female asthmatics on long-term corticosteroid treatment. Current interest in lipid metabolism centres on the high density lipoproteins and their inverse relationship to ischaemic heart disease (Gordon et al, 1977).…”

Section: Introductionmentioning

confidence: 99%

Corticosteroid treatment, serum lipids and coronary artery disease

Jefferys

Lessof

Mattock

1980

Postgraduate Medical Journal

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Serum lipids and the cholesterol concentrations in the high density lipoprotein (HDL) fractions were measured in patients receiving long-term corticosteroid treatment for connective tissue disorders and asthma. Patients who were not receiving corticosteroid treatment had blood lipid levels which did not differ from those of healthy people. However, female (but not male) patients who had received prednisolone for a mean period of 3.1 years had a significant elevation in total cholesterol and a large decrease in HDL cholesterol. It seems possible that high levels of corticosteroids may increase the incidence of premenopausal ischaemic heart disease in females.

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“…We were interested in examining carbohydrate metabolism in consecutively admitted patients with pathologically proven endogenous Cushing syndrome by measuring plasma levels of fasting glucose, HbAlc and levels of glucose and insulin before and during a 75 g OGTT and correlating these parameters with indices of hypercortisolism. Long term administration of glucocorticoids results in elevated cholesterol and triglyceride levels [18,19] and there is a correlation between plasma cortisol and coronary atherosclerosis in patients undergoing coronary angiography [20]. Additionally, patients with Cushing syndrome [21] On a separate occasion, after a 10 h fast, patients underwent a 75 g OGTT.…”

mentioning

confidence: 99%

Carbohydrate and Lipid Metabolism in Endogenous Hypercortisolism: Shared Features with Metabolic Syndrome X and NIDDM.

et al. 1996

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Abstract.Carbohydrate and lipid metabolism was cross-sectionally assessed in 16 patients with endogenous hypercortisolism (endogenous Cushing syndrome). Five patients (31%) had fasting glucose levels over 6.6 mmol/l and a HbAic over 7.5%. Six patients (38%) had diabetes mellitus based on an abnormal 75 g oral glucose tolerance test (OGTT) and two additional patients (13%) had impaired glucose tolerance based on an OGTT. Compared to obese individuals, patients with Cushing syndrome had an elevated glucose but no elevated insulin response to the OGTT. Regression analysis showed positive correlations between 24-h urinary free cortisol (UFC) and fasting blood glucose (P<0.0005), UFC and OGTT glucose area under the curve (AUC) (P<0.01), and UFC and HbAlc (P<0.005). UFC levels were negatively correlated (P<0.05) with OGTT insulin AUC and insulin/glucose ratios. Eleven (69%) patients required anti-hypertensive therapy for blood pressure control. Total cholesterol and triglycerides were elevated in patients with Cushing syndrome compared to obese controls, while LDL and HDL cholesterol, and Lp(a) were similar in the two groups. We conclude that impaired glucose tolerance and/or diabetes in patients with endogenous Cushing syndrome is due to the hyperglycemic effects of cortisol with relative insulinopenia.Thus, Cushing syndrome shares features with both the Metabolic Syndrome X and NIDDM, including impaired glucose uptake, hyperlipidemia and hypertension.However, in Cushing syndrome, a relative insulinopenia occurs, while in Metabolic Syndrome X and NIDDM, insulin excess is observed. In Cushing syndrome, as the hypercortisolemia exacerbates, insulinopenia becomes more paramount, suggesting that cortisol exerts a direct or indirect "toxic" effect on the fl -cell .

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Hyperlipidaemia in Asthmatic Patients Receiving Long-term Steroid Therapy

Cited by 77 publications

References 12 publications

Aging and Hypothalamic-Pituitary-Adrenal Response to Challenge in Humans*

Aging and Hypothalamic-Pituitary-Adrenal Response to Challenge in Humans*

Corticosteroid treatment, serum lipids and coronary artery disease

Carbohydrate and Lipid Metabolism in Endogenous Hypercortisolism: Shared Features with Metabolic Syndrome X and NIDDM.

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