%0 Journal Article
%T Serum Fructosamine, Total Cholesterol, and High-Density Lipoprotein in Children with Asthma during Glucocorticoid Treatment
%A A. J. Schou
%A O. D. Wolthers
%J ISRN Allergy
%D 2011
%R 10.5402/2011/295124
%X Background/Aims. Glucocorticoids may have adverse effects on carbohydrate and lipid metabolism. The present study was conducted to investigate possible effects on carbohydrate and lipid metabolism of inhaled and oral glucocorticoids in children with asthma. Methods. Two randomised controlled trials with blinded crossover designs were performed. Active treatment was 400£¿¦Ìg inhaled budesonide or 5£¿mg prednisolone orally daily during one week. The budesonide trial included 17 and the prednisolone trial 20 school children. Serum fructosamine, total cholesterol and high-density lipoprotein were assessed. Results. Serum fructosamine was increased during active treatment (prednisolone 252.3£¿¦ÌM versus placebo 247.3£¿¦ÌM; P = 0.03 and budesonide 228.1£¿¦ÌM versus no treatment 223.1£¿¦ÌM; P = 0.02). Total cholesterol and high-density lipoprotein were not statistically significantly increased. Conclusion. Short-term treatment with oral prednisolone and inhaled budesonide may adversely affect mean blood glucose concentration. Possible long-term consequences require further investigations. 1. Introduction Asthma is the most common chronic childhood disease [1]. Inhaled glucocorticoids are widely recommended as first-line treatment [2], and short-term treatment with oral glucocorticoids is often used during exacerbations [3]. Exogenous glucocorticoids¡ªinhaled as well as oral¡ªmay cause a wide range of dose-dependent adverse systemic effects [4, 5]. These include suppression of hypothalamic-pituitary-adrenal function, growth retardation, catabolic effects on bone metabolism, suppressive effects on connective tissue including atrophy of the skin, cataracts, haematological effects, and, finally, but not least, metabolic effects [5, 6]. The metabolic effects include elevated serum glucose concentration and hyperlipidaemia, both of which are closely linked to the ¡°Metabolic Syndrome¡± with a greatly increased risk for cardiovascular disease, stroke, and type II diabetes [7, 8]. Such glucocorticoid-induced effects are mediated by binding to receptors in the liver and in muscle as well as adipose tissue and may partly be due to reduced insulin sensitivity [7¨C9]. Little attention has been paid to the possible effects of glucocorticoid treatment on carbohydrate and lipid metabolism in children despite potentially very harmful long-term consequences. The effects of inhaled glucocorticoids which often may be used during many years in the treatment of asthma have been studied few times in adults [10¨C12] and once in children [13]. These studies were flawed by methodological shortcomings,
%U http://www.hindawi.com/journals/isrn.allergy/2011/295124/