The Incidence And Related Factors Of Steroid-induced Hyperglycemia In SLE Patients Treated With Glucocorticoid

Objective: To retrospective analyzed the clinical data and the occurrence of steroid-induced hyperglycemia in SLE patients treated with glucocorticoid,and analyzed its related factors,providing reference for prevention of steroid-induced hyperglycemia and clinical treatment.Material and methods:(1)The subjects: 63 SLE patients in The First Hospital of Ji Lin University and The Second Hospital of Ji Lin Univers ity from January 2016 to December 2016 were analyzed.(2)Admission criteria: SLE patients received glucocorticoid treatment during hospitalization;no previous history of diabetes and normal blood glucose before glucocorticoid treatment;monitored for blood glucose,uric acid,serum lipids,C reactive protein and blood pressure during hospitalization;received telephone return visit,had multiple inpatient or outpatient review of clinical data.(3)Exc lusion criteria: SLE patients had impaired glucose tolerance or diabetes mellitus before glucocorticoid therapy;had previous history of glucocorticoid before SLE;SLE combined with other diseases requiring glucocorticoid therapy.(4)Methods: The general data were collected;the laboratory examination data were collected;through telephone return visit to collect the data of the SLE pat-ients: the time and dose of glucocorticoid therapy,steroidinduced hyperglycemia;the SLE patients were divided into the steroid-induced hyper-glycemia group and the normal blood glucose group according to the monitoring of blood glucose during hospitalization and the results of telephone call outside hospital.Statistics: SPSS 20.0 were used for statistic analysis.p<0.05 was regarded as significant.Result:(1)In 63 SLE patients,15 patients(23.81%)were identified with steroid-induced hyperglycemia,including prediabetes(7.94%)and steroid-induced diabetes mellitus(15.87%).Normal blood glucose group 48 cases,accounting for 76.19%.In 15 patients with steroid-induced hyperglycemia,9 patients occurred within 12 weeks of glucocorticoid treatment,4 patients occurred within 24 weeks of glucocorticoid treatment,and the other 2 patients occurred after 24 weeks of glucocorticoid treatment.Steroid-induced diabetes was characterized by increased postprandial blood glucose,especially after lunch and after dinner.(2)Comparison of two groups,there was statistical significance in age,body mass index,the family history of diabetes,the initial glucocorticoid dose,glucocorticoid shock therapy and hypertriglyceridemia(p < 0.05),it means that the age,body mass index,the proportion of family history of diabetes,the initial glucocorticoid dose,the proportion of glucocorticoid shock therapy and of the steroid-induced hyperglycemia group are higher than the normal blood glucose group;the gender,SLEDAI,lupus nephritis,hypertension,the time of glucocorticoid therapy,inhibitors immune,the FBG before glucocorticoid therapy,hypercholesterolemia,hyperuricemia and C reactive protein had no significant difference(p>0.05).(3)The results of logistic regression indicated that the older,the greater the body mass index and the higher the initial glucocorticoid dose is the risk factor for steroid-induced hyperglycemia in patients with systemic lupus erythematosus treated with glucocorticoid.Conclusion(1)SLE patients treated with glucocorticoid,the prevalenees of steroid-induced hyperglycemia was higher(23.81%,inc luding prediabetes was 7.94% and steroid-induced diabetes mellitus was 15.87%).(2)The time of the incidence of steroid-induced hyperglycemia in SLE patients treated with glucocorticoid was earlier,the most within 12 weeks after glucocorticoid treatment.(3)Steroid-induced diabetes in SLE patients treated with glucocorticoid was characterized by increased postprandial blood glucose,esp-ecially after lunch and dinner.(4)The older,the greater the body mass index and the higher the initial glucocorticoid dose of the SLE patients,the higher possibility of steroid-induced hyperglycemia.