Skip to main content

Advertisement

SpringerLink
Log in

Effect of Glucocorticoids on Serum Lipid Profile and Endothelial Function and Arterial Wall Mechanics

  • Original Article
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Objective

To determine the effect of glucocorticoids on lipid profile, endothelial function and arterial wall mechanics in children.

Methods

Thirty patients who had received glucocorticoids for 4 to 8 wk were compared with 30 age and sex matched healthy controls. Baseline evaluation included weight, height, body mass index (BMI), blood pressure (BP), lipid profile and Ultrasonographic evaluation of brachial artery for endothelial dependant as well as endothelial independent vasodilatation and evaluation of common carotid artery for intima media thickness (IMT) and arterial wall mechanics. All of these parameters were evaluated two more times- after 4 wk of steroid therapy and 2 wk after stopping the drug.

Results

Patients were found to have significant increase in BMI; systolic and diastolic BP; total and LDL cholesterol and carotid IMT and also a decrease in cross sectional compliance (CSC) after 4 wk of steroid therapy (oral prednisolone). However, all these parameters returned towards baseline, 2 wk after stopping the drug. No endothelial dysfunction was observed in these patients.

Conclusions

Four to eight wk of glucocorticoids use in children leads to reversible changes in BMI, systolic and diastolic BP, total and LDL cholesterol, carotid IMT and CSC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Sader MA, Celermajer DS. Endothelial function, vascular reactivity and gender differences in the cardiovascular system. Cardiovasc Res. 2002;53:597–604.

    Article  PubMed  CAS  Google Scholar 

  2. Celermajer DS, Sorensen KE, Gooch VM, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet. 1992;340:1111–5.

    Article  PubMed  CAS  Google Scholar 

  3. Widlansky ME, Gokce N, Keaney Jr JF, Vita JA. The clinical implications of endothelial dysfunction. J Am Coll Cardiol. 2003;42:1149–60.

    Article  PubMed  CAS  Google Scholar 

  4. Krieger M, Stern DM. Series introduction: Multiligand receptors and human diseases. J Clin Invest. 2001;108:645–7.

    PubMed  CAS  Google Scholar 

  5. Morel DW, DiCorleto PE, Chisolm GM. Endothelial and smooth muscle cells alter low density lipoprotein in vitro by free radical oxidation. Arteriosclerosis. 1984;4:357–64.

    Article  PubMed  CAS  Google Scholar 

  6. Anderson TJ, Uehata A, Gerhard MD, et al. Close relation of endothelial function in the human coronary and peripheral circulations. J Am Coll Cardiol. 1995;26:1235–41.

    Article  PubMed  CAS  Google Scholar 

  7. Gokce N, Keaney Jr JF, Hunter LM, et al. Predictive value of noninvasively determined endothelial dysfunction for long-term cardiovascular events in patients with peripheral vascular disease. J Am Coll Cardiol. 2003;41:1769–75.

    Article  PubMed  Google Scholar 

  8. Corrado E, Rizzo M, Coppola G, Muratori I, Carella M, Novo S. Endothelial dysfunction and carotid lesions are strong predictors of clinical events in patients with early stages of atherosclerosis; A 24-month follow–up study. Coron Artery Dis. 2008;19:139–44.

    Article  PubMed  Google Scholar 

  9. Suwaidi JA, Hamasaki S, Higano ST, Nishimura RA, Holmes DR Jr, Lerman A. Long-term follow-up of patients with mild coronary artery disease and endothelial dysfunction. Circulation. 2000;101:948–54.

    Article  PubMed  CAS  Google Scholar 

  10. Schächinger V, Britten MB, Zeiher AM. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation. 2000;101:1899–906.

    Article  PubMed  Google Scholar 

  11. Iglesias del Sol A, Bots ML, Grobbee DE, Hofman A, Witteman JC. Carotid intima-media thickness at different sites: Relation to incident myocardial infarction; The Rotterdam study. Eur Heart J. 2002;23:934–94.

    Article  PubMed  CAS  Google Scholar 

  12. Tounian P, Aggoun Y, Dubern B, et al. Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: A prospective study. Lancet. 2001;358:1400–4.

    Article  PubMed  CAS  Google Scholar 

  13. Aggoun Y, Bonnet D, Sidi D, et al. Arterial mechanical changes in children with familial hypercholesterolemia. Arterioscler Thromb Vasc Biol. 2000;20:2070–5.

    Article  PubMed  CAS  Google Scholar 

  14. Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M, Alzola C. Carotid atherosclerosis measured by B-mode ultrasound in populations: Associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol. 1991;134:250–6.

    PubMed  CAS  Google Scholar 

  15. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: A direct measurement with ultrasound imaging. Circulation. 1986;74:1399–406.

    Article  PubMed  CAS  Google Scholar 

  16. Leeson P, Thorne S, Donald A, Mullen M, Clarkson P, Deanfield J. Non-invasive measurement of endothelial function: Effect on brachial artery dilatation of graded endothelial dependent and independent stimuli. Heart. 1997;78:22–7.

    PubMed  CAS  Google Scholar 

  17. Kumar V, Sachdev HPS, Khalil A. Noninvasive evaluation of endothelial function and arterial mechanics in overweight adolescents. Indian Pediatr. 2004;41:1105–14.

    PubMed  Google Scholar 

  18. Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972;18:499–502.

    PubMed  CAS  Google Scholar 

  19. Park MK. Pediatric Cardiology for Practitioners. India: Mosby Elsevier; 2009. pp. 595. Appendix C.

    Google Scholar 

  20. Thakore AH, Guo CY, Larson MG, et al. Association of multiple inflammatory markers with carotid intimal medial thickness and stenosis (from the Framingham Heart Study). Am J Cardiol. 2007;99:1598–602.

    Article  PubMed  Google Scholar 

  21. Maxwell SR, Moots RJ, Kendall MJ. Corticosteroids: Do they damage the cardiovascular system? Postgrad Med J. 1994;70:863–70.

    Article  PubMed  CAS  Google Scholar 

  22. Ettinger WH, Klinefelter HF, Kwiterovitch PO. Effect of short-term, low-dose corticosteroids on plasma lipoprotein lipids. Atherosclerosis. 1987;63:167–72.

    Article  PubMed  CAS  Google Scholar 

  23. Zimmerman J, Fainaru M, Eisenberg S. The effects of prednisone therapy on plasma lipoproteins and apolipoproteins: A prospective study. Metabolism. 1984;33:521–6.

    Article  PubMed  CAS  Google Scholar 

  24. Choi HK, Seeger JD. Glucocorticoid use and serum lipid levels in US adults: The Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;53:528–35.

    Article  PubMed  CAS  Google Scholar 

  25. Lau KK, Tancredi DJ, Perez RV, Butani L. Unusual pattern of dyslipidemia in children receiving steroid minimization immunosuppression after renal transplantation. Clin J Am Soc Nephrol. 2010;5:1506–12.

    Article  PubMed  Google Scholar 

  26. Boers M, Nurmohamed MT, Doelman CJ, et al. Influence of glucocorticoids and disease activity on total and high density lipoprotein cholesterol in patients with rheumatoid arthritis. Ann Rheum Dis. 2003;62:842–5.

    Article  PubMed  CAS  Google Scholar 

  27. Faggiano A, Pivonello R, Spiezia S, et al. Cardiovascular risk factors and common carotid artery calibre and stiffness in patients with Cushing’s disease during active disease and 1 year after disease remission. J Clin Endocrinol Metab. 2003;88:2527–33.

    Article  PubMed  CAS  Google Scholar 

  28. Chan MK, Varghese Z, Moorhead JF. Lipid abnormalities in uremia, dialysis, and transplantation. Kidney Int. 1981;19:625–37.

    Article  PubMed  CAS  Google Scholar 

  29. Whitworth JA, Williamson PM, Mangos G, Kelly JJ. Cardiovascular consequences of cortisol excess. Vasc Health Risk Manag. 2005;1:291–9.

    Article  PubMed  CAS  Google Scholar 

  30. Whitworth JA, Mangos GJ, Kelly JJ. Cushing, cortisol, and cardiovascular disease. Hypertension. 2000;36:912–6.

    Article  PubMed  CAS  Google Scholar 

Download references

Contributions

TPY, RA, NS, AC: Conceptualized the study and reviewed literature; TPY, AY, NS, AC, AJ and RA: Collected the data and drafted the manuscript; TPY, AY and AJ: Critically evaluated the paper and finalized the draft.

Conflict of Interest

None.

Role of Funding Source

None.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India

    Anita Yadav, Afsana Jahan, Tribhuvan Pal Yadav & Ram Asare

  2. Deparmentt of Radiology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India

    Namrita Sachdev

  3. Department of Biochemistry, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India

    Anubhuti Chitkara

  4. H 1571 GF, Chittaranjan Park, New Delhi, 110019, India

    Tribhuvan Pal Yadav

Authors
  1. Anita Yadav
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Afsana Jahan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tribhuvan Pal Yadav
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Namrita Sachdev
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Anubhuti Chitkara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ram Asare
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tribhuvan Pal Yadav.

Additional information

Contributions

TPY, RA, NS, AC: Conceptualized the study and reviewed literature; TPY, AY, NS, AC, AJ and RA: Collected the data and drafted the manuscript; TPY, AY and AJ: Critically evaluated the paper and finalized the draft.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yadav, A., Jahan, A., Yadav, T.P. et al. Effect of Glucocorticoids on Serum Lipid Profile and Endothelial Function and Arterial Wall Mechanics. Indian J Pediatr 80, 1007–1014 (2013). https://doi.org/10.1007/s12098-013-1035-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12098-013-1035-6

Keywords

Search

Navigation