Department of Primary Care and Population Health, University College London, London, UK.
Department of Dermatology, Henri Mondor Hospital, Créteil, France.
Rheumatology (Oxford). 2021 Mar 2;60(3):1502-1511. doi: 10.1093/rheumatology/keaa289.
To describe the variation in weight gain in people chronically exposed to systemic glucocorticoids in primary care and to identify the risk factors for weight gain.
Data were analysed from the British database, The Health Improvement Network. Body weight variations of individuals prescribed systemic glucocorticoids for at least 3 months at a mean dose ≥10 mg/day were described. The risk factors associated with weight gain ≥10% of the usual weight were assessed.
A total of 31 516 adults prescribed glucocorticoids and 26 967 controls were included in the study. During glucocorticoid exposure, only 12 475 (39.6%) individuals gained >2 kg compared with their usual weight. Younger women were more likely to gain weight (mean weight gain in 18-39-year-old glucocorticoid-exposed women: 3.6 kg (s.d. 8.6) compared with 2 kg (s.d. 7.3) in the control group; the absolute mean difference was 1.6 kg (95% CI 0.9, 2.2; P < 0.001). Weight gain ≥10% of the usual weight was observed in 10.2% (n = 3208) of those chronically exposed to glucocorticoids. Women, younger people, those living in areas of higher deprivation, smokers, those on higher doses of the drug and those previously exposed to glucocorticoids were at higher risk. The risk was lower in people prescribed glucocorticoids for an inflammatory condition when compared with asthma or chronic obstructive pulmonary disease.
After taking into account usual weight rather than weight just before glucocorticoid initiation and the natural history of weight variation, the amount of weight gain induced by systemic glucocorticoids as prescribed in primary care is less than usually thought.
18THIN081.
描述在初级保健中长期接受全身糖皮质激素治疗的人群体重增加的变化，并确定体重增加的危险因素。
分析了英国数据库 The Health Improvement Network 的数据。描述了至少连续 3 个月每天接受剂量≥10mg 全身糖皮质激素治疗的个体体重变化。评估了体重增加≥通常体重的 10%的相关危险因素。
共纳入 31516 名接受糖皮质激素治疗的成年人和 26967 名对照者。在糖皮质激素暴露期间，仅有 12475 人（39.6%）体重增加超过 2kg。年轻女性更容易增重（18-39 岁接受糖皮质激素治疗的女性体重增加的平均体重为 3.6kg（标准差 8.6），对照组为 2kg（标准差 7.3）；绝对平均差异为 1.6kg（95%置信区间 0.9，2.2；P<0.001）。在长期接受糖皮质激素治疗的患者中，有 10.2%（n=3208）的患者体重增加≥通常体重的 10%。女性、年轻人、生活在贫困程度较高地区的人、吸烟者、接受较高剂量药物治疗的人以及之前接受过糖皮质激素治疗的人风险更高。与哮喘或慢性阻塞性肺疾病相比，因炎症性疾病而接受糖皮质激素治疗的患者风险较低。
在考虑到通常体重而不是开始使用糖皮质激素之前的体重，以及体重变化的自然史后，初级保健中按规定使用全身糖皮质激素引起的体重增加量比通常认为的要少。
18THIN081。
