13047
document
Short-term effects of prednisolone and dexamethasone on circulating concentrations of leptin and sex hormone-binding globulin in children being treated for acute lymphoblastic leukaemia . OBJECTIVE Disturbances in body weight regulation are often encountered during glucocorticoid treatment and are associated with increased insulin resistance and truncal fat accumulation . Children were investigated who were receiving glucocorticoid treatment for acute lymphoblastic leukaemia ( ALL ) . They were randomized to receive either prednisolone or dexamethasone as part of induction of remission . This randomization process provided a suitable opportunity to compare the effects of these two administered steroid on surrogate markers of adipocyte activity ( leptin ) and hyperinsulinaemia/insulin resistance ( SHBG ) . DESIGN AND PATIENTS Prospective study over 16 weeks of children randomized to receive prednisolone ( 40 mg/m2 ) or dexamethasone ( 6.5 mg/m2 ) as part of the MRC-ALL97/99 induction chemotherapy for ALL . Nineteen children ( 8 male , 11 female ) with a median age 5.9 years ( range 2.6-13 years ) were recruited into the study . Main outcome measures were body mass index ( BMI ) , serum leptin and sex hormone binding globulin ( SHBG ) . RESULTS Glucocorticoid administration for 5 weeks resulted in significant ( P < 0.05 ) increases in BMI , leptin ( corrected for BMI ) and the leptin : SHBG ratio and lowering of SHBG . Dose for dose , dexamethasone was significantly more potent than prednisolone in altering these parameters . CONCLUSIONS Short-term glucocorticoid treatment has significant effects on BMI , leptin and SHBG . The leptin : SHBG ratio increase indicates that this may be a novel and sensitive biochemical marker of metabolic change . Our results suggest that glucocorticoid treatment regimens should be kept as short as possible to avoid possible detrimental effects associated with increased adiposity and insulin resistance .
13048
Intervention_Pharmacological
prednisolone
13049
Intervention_Pharmacological
dexamethasone
13050
Intervention_Pharmacological
glucocorticoid
13051
Intervention_Pharmacological
glucocorticoid
13052
Intervention_Pharmacological
prednisolone
13053
Intervention_Pharmacological
dexamethasone
13054
Intervention_Pharmacological
prednisolone
13055
Intervention_Pharmacological
dexamethasone
13056
Intervention_Pharmacological
induction chemotherapy
13057
Intervention_Pharmacological
dexamethasone
13058
Intervention_Pharmacological
prednisolone
13059
Intervention_Pharmacological
glucocorticoid
13060
Outcome_Physical
circulating concentrations of leptin and sex hormone-binding globulin
13061
Outcome_Physical
body mass index ( BMI )
13062
Outcome_Physical
serum leptin and sex hormone binding globulin ( SHBG )
13063
Outcome_Physical
BMI
13064
Outcome_Physical
leptin ( corrected for BMI ) and the leptin : SHBG ratio and lowering of SHBG
13065
Participant_Age
children
13066
Participant_Condition
acute lymphoblastic leukaemia
13067
Participant_Age
Children
13068
Participant_Condition
acute lymphoblastic leukaemia ( ALL )
13069
Participant_Age
children
13070
Participant_Sample-size
Nineteen
13071
Participant_Age
children
13072
Participant_Sample-size
8
13073
Participant_Sex
male
13074
Participant_Sample-size
11
13075
Participant_Sex
female
13076
Participant_Age
5.9 years
13077
Participant_Age
2.6-13