Steroid‐induced diabetes mellitus in systemic lupus erythematosus patients: analysis from a <scp>M</scp>alaysian multi‐ethnic lupus cohort

Shaharir, Syahrul Sazliyana; Gafor, Abdul Halim Abdul; Said, Mohd Fuaad; Kong, Norella C T

doi:10.1111/1756-185x.12474

Cited by 30 publications

(23 citation statements)

References 49 publications

(53 reference statements)

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“…We found higher baseline glucose and IFG to be associated with NODAG, consistent with similar findings in solid‐organ transplant . Hyperlipidaemia and lower HDL‐C were associated with NODAG in our cohort, as well as incident diabetes in individuals with systemic lupus erythematosus and in the general population, likely reflecting the underlying metabolic syndrome . We also found proteinuria to be associated with NODAG (Fig.…”

Section: Discussionsupporting

confidence: 89%

“…[12][13][14] Hyperlipidaemia and lower HDL-C were associated with NODAG in our cohort, as well as incident diabetes in individuals with systemic lupus erythematosus and in the general population, likely reflecting the underlying metabolic syndrome. 15,16 We also found proteinuria to be associated with NODAG ( Fig. 1).…”

Section: Discussionsupporting

confidence: 57%

“…While it was associated with metabolic syndrome among lupus patients, the association was diminished after adjusting for age, body mass index (BMI) and proteinuria . Other immunosuppressants, such as mycophenolate mofetil and hydroxychloroquine, have been reported to affect diabetes risks in a few rheumatologic cohorts . Concurrent mycophenolate use with high‐dose glucocorticosteroids predisposed Koreans with systemic lupus erythematosus to diabetes, while hydroxychloroquine reduced diabetes risk in Taiwanese and Malaysians with lupus …”

Section: Discussionmentioning

confidence: 99%

“…30 Other immunosuppressants, such as mycophenolate mofetil and hydroxychloroquine, have been reported to affect diabetes risks in a few rheumatologic cohorts. 15,31,32 Concurrent mycophenolate use with high-dose glucocorticosteroids predisposed Koreans with systemic lupus erythematosus to diabetes, 31 while hydroxychloroquine reduced diabetes risk in Taiwanese and Malaysians with lupus. 15,32 More recently, meta-analyses of trials and observational studies found that statin increased diabetes risk.…”

Section: Incident Diabetes In Glomerulonephritismentioning

confidence: 99%

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New‐onset diabetes mellitus among patients with glomerular diseases

Lim

Wong

Koh

et al. 2019

Internal Medicine Journal

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Incident Diabetes In Glomerulonephritismentioning

confidence: 99%

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New‐onset diabetes mellitus among patients with glomerular diseases

Lim

Wong

Koh

et al. 2019

Internal Medicine Journal

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“…Antimalarial agents have been used to treat SLE in over 50 years and since 1990s, there is well-established evidence of its various benefits including anti-thrombotic, anti-hyperlipidaemic, prevention of disease flares and damage in lupus [38]. Our previous studies have also found that the use of HCQ was associated with less disease damage in a small lupus nephritis cohort [35] and was associated with less SDM complication [45]. …”

Section: Discussionmentioning

confidence: 99%

Damage in the Multiethnic Malaysian Systemic Lupus Erythematosus (SLE) Cohort: Comparison with Other Cohorts Worldwide

et al. 2016

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Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease and despite the improvement in the survival in the past few decades, the morbidity due to disease damage remains significant. The objectives of this study were to investigate the disease damagepattern and determine the associated factors of damage in the multi-ethnic Malaysian SLE patients. We consecutively 424SLE patients who attended a consistent follow-up at the National University of Malaysia Medical Centre and Putrajaya Hospital were recruited. Disease damage was assessed using the SLICC/ACR (Systemic Lupus International Collaborating Clinics/American College of Rheumatology) Damage Index (SDI) scores. Information on their demographics and disease characteristics were obtained from the clinical record. Univariate analysis was performed and the best model of independent predictors of disease damage was determined by multivariate logistic regression analysis. A total of 182 patients (42.9%) had disease damage (SDI ≥1). A significantly higher number of Indian patients had disease/organ damage and they predominantly developed steroid-induced diabetes mellitus (SDM). Patients with corticosteroid-induced osteoporosis (CIOP) were more likely to be Malayswhile majority of patients who developed malignancy were Chinese (p<0.05). In the univariate and multivariate analyses, disease damage was significantly associated with age, Indian ethnicity, lower mean cumulative C3 level, neuropsychiatry lupus (NPSLE), and antiphospholipid syndrome (APLS). Patients who had ever and early treatment with hydroxychloroquine(HCQ)were less likely to develop disease damage while more patients who had received oral prednisolone ≥1mg/kg daily over 2 weeks had disease damage (p<0.05). In conclusion, there were inter-ethnic differences in the damage pattern and risks among SLE patients.

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