Dexa Study On Changes In Body Composition After Long-term Glucocorticoid Therapy

Objective: To study changes of body composition after long-termglucocorticoid therapy by Dual Energy X-ray Absorptiometry (DEXA),providing the important information about prevention and treatment ofcardio-cerebrovascular disease、Metabolic syndrome、osteoporosis、obesity andits complication.Material&Methods: Recruited20patients receiving glucocorticoidtherapy in the First Affiliated Hospital of Guangxi medical university duringJanuary to December in2011. The mean age is45.74±18.57, there are8malepatients, with height of163.25±4.86cm,weight of63.75±13.27kg, BMI of23.97±5.04, and12female with height of153.17±6.34cm, weight of53.67±10.79kg, BMI of22.82±4.02.20patients were recruited for serialmeasurements (months0-3, months3-6and months6-9) of body composition[FAT%, Fat and Lean] and bone mineral density (BMD) by dual energy X-rayabsorptiometry scan after high-dose oral glucocorticoid therapy. The researchincluding the following items:1.to detect the DEXA statistics data of the totalbody and the parts of body including FAT％, FAT, LEAN and BMD after glucocorticoid therapy at different time;2.to statistically analyze theDEXA statistics data of the total body and the parts of body including FAT％,FAT, LEAN and BMD after glucocorticoid therapy at different time;3.tostatistically analyze the correlation between BMI and BMD,4.tostatistically analyze the correlation between FAT%、FAT of the whole bodyand BMD,5.to statistically analyze the correlation between FAT%、FAT、LEAN、BMD of the thunk and the whole body and the use time of theglucocorticoid.Results:1.At3-6moths, a significant increase in FAT%of the whole bodycompared with at0-3months （P<0.05）, especially in the trunk（P<0.01）, buta non-significant changes in FAT、LEAN、BMC and BMD of the whole body.At6-9months, a significant increase in FAT%of the whole body comparedwith at0-3months（P<0.05）, and so was the FAT of the legs，limbs and trunk.Asignificant drop in LEAN of the trunk and the whole body (P<0.05) alsooccurred;2. A non-significant drop in BMD of all parts of the body afterlong-term glucocorticoid therapy(p＞0.05);3. positive correlation was shownamong BMI and BMD of the whole body （r=0.489，P=0.001）;4. The changesin BMD of the whole body is significant positive correlation with LEAN (r were0.77,0.675,0.389,0.553, P <0.01);5. The changes in FAT%、FAT of trunk andtotal body is significant positive correlation with the use time of theglucocorticoid (r were0.507、0.499、0.476, P <0.01).Conclusion:1. There is a significant increase in FAT%of all parts of thebody, especially in the trunk, after long-term glucocorticoid therapy. It pointout that long-term glucocorticoid therapy increased Trunk FAT%has asignificantly increasing risk in the incidence of cardio-cerebrovascular diseaseand Metabolic syndrome;2. The LEAN of trunk and total body gradually reduce with the use time of the glucocorticoid;3. when calcium and vitaminD supplementation is added to prolonged GC therapy, its negativeeffects on bone fail to materialize;4. The changes in total body BMD issignificant positive correlation with BMI,and all parts of the body BMD showpositive correlation with LEAN,it suggest that the person with greater BMIwould not easy to be osteoporotic;5. The changes in FAT%、FAT oftrunk and total body is significant positive correlation with the use time of theglucocorticoid. It point out that the longer glucocorticoid taken, themore central obesity would become.