Steroid-induced diabetes mellitus in systemic lupus erythematosus patients: Analysis from a Malaysian multi-ethnic lupus cohort

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Abstract

Objective: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE. Methodology: A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM. Results: Thirteen of them (13%) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05). Conclusion: The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.

Original languageEnglish
Pages (from-to)541-547
Number of pages7
JournalInternational Journal of Rheumatic Diseases
Volume18
Issue number5
DOIs
Publication statusPublished - 1 Jun 2015

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Systemic Lupus Erythematosus
Diabetes Mellitus
Steroids
Hydroxychloroquine
Abdominal Obesity
Hypertriglyceridemia
Prednisolone
Glucocorticoids
Nephrology
Malaysia
Rheumatology
Autoimmune Diseases
Adrenal Cortex Hormones
Chronic Disease
Therapeutics
Multivariate Analysis

Keywords

  • Clinical aspects
  • SLE drug treatment
  • Systemic lupus erythematous

ASJC Scopus subject areas

  • Rheumatology

Cite this

@article{c4d10c484e554549911675495ce30773,
title = "Steroid-induced diabetes mellitus in systemic lupus erythematosus patients: Analysis from a Malaysian multi-ethnic lupus cohort",
abstract = "Objective: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53{\%}. We sought to investigate the prevalence and associated factors of SDM in patients with SLE. Methodology: A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM. Results: Thirteen of them (13{\%}) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9{\%}) had SDM compared to Malays (9.3{\%}) and Chinese (12.8{\%}) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05). Conclusion: The prevalence of SDM among SLE patients was 13{\%} and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.",
keywords = "Clinical aspects, SLE drug treatment, Systemic lupus erythematous",
author = "Shaharir, {Syahrul Sazliyana} and {Abdul Gafor}, {Abdul Halim} and {Mohamed Said}, {Mohd Shahrir} and Kong, {Norella C T}",
year = "2015",
month = "6",
day = "1",
doi = "10.1111/1756-185X.12474",
language = "English",
volume = "18",
pages = "541--547",
journal = "International Journal of Rheumatic Diseases",
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TY - JOUR

T1 - Steroid-induced diabetes mellitus in systemic lupus erythematosus patients

T2 - Analysis from a Malaysian multi-ethnic lupus cohort

AU - Shaharir, Syahrul Sazliyana

AU - Abdul Gafor, Abdul Halim

AU - Mohamed Said, Mohd Shahrir

AU - Kong, Norella C T

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Objective: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE. Methodology: A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM. Results: Thirteen of them (13%) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05). Conclusion: The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.

AB - Objective: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease and glucocorticoid is the mainstay of treatment in SLE. The reported incidence of steroid-induced diabetes mellitus (SDM) ranged between 1-53%. We sought to investigate the prevalence and associated factors of SDM in patients with SLE. Methodology: A total of 100 SLE patients attending the Nephrology/SLE and Rheumatology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC) who received corticosteroid treatment were recruited. The diagnosis of diabetes mellitus was based on the 2010 American Diabetes Association's criteria. Prevalent cases of SDM were also included. Statistical analysis was performed to determine the factors associated with SDM. Results: Thirteen of them (13%) developed SDM, with the median onset of diagnosis from commencement of glucocorticoid treatment being 8 years (range 0.5-21 years). Although only seven Indians were recruited into the study, three of them (42.9%) had SDM compared to Malays (9.3%) and Chinese (12.8%) (P ≤ 0.05). Univariate and multivariate analysis showed that higher numbers of system or organ involvement in SLE, abdominal obesity, hypertriglyceridemia and daily prednisolone of ≥ 1 mg/kg/day were the important associated factors of SDM (P ≤ 0.05). Meanwhile, hydroxychloroquine (HCQ) use was associated with reduced SDM prevalence (P < 0.05). Conclusion: The prevalence of SDM among SLE patients was 13% and Indians were more prone to develop SDM compared to other races. Higher numbers of system involvement, abdominal obesity, hypertriglyceridemia and the use of oral prednisolone of ≥ 1 mg/kg/day were associated with SDM, while HCQ use potentially protects against SDM.

KW - Clinical aspects

KW - SLE drug treatment

KW - Systemic lupus erythematous

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U2 - 10.1111/1756-185X.12474

DO - 10.1111/1756-185X.12474

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JO - International Journal of Rheumatic Diseases

JF - International Journal of Rheumatic Diseases

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