Changes of blood glucose level after glucocorticoid pulse therapy and its influencing factors in patients with Graves ophthalmopathy
10.3760/cma.j.issn.1008-5734.2019.03.008
- VernacularTitle:Graves眼病患者糖皮质激素冲击治疗后血糖水平变化及其影响因素
- Author:
Zhihui SONG
1
;
Zhong XIN
;
Xinglong WANG
;
Pengpeng LIU
;
Jiawei WANG
Author Information
1. 首都医科大学附属北京同仁医院药学部 100730
- Publication Type:Journal Article
- Keywords:
Graves ophthalmopathy;
Glucocorticoids;
Blood glucose;
Diabetes mellitus
- From:
Adverse Drug Reactions Journal
2019;21(3):203-207
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the changes of blood glucose level after glucocorticoid pulse therapy (GPT) and its influencing factors in patients with Graves ophthalmopathy (GO).Methods Medical records of GO patients hospitalized in Beijing Tongren Hospital from January 1,2013 to December 31,2018 and treated with GPT were collected and retrospectively analyzed.The incidence of glucocorticoid-induced diabetes mellitus (GIDM) during the GPT treatment (3 days) was counted.According to the monitoring data of fasting blood glucose (FBG) and postprandial blood glucose (PBG),the changes of FBG and PBG levels were calculated.Influencing factors for FBG and PBG levels were evaluated by multiple linear stepwise regression analysis.Results A total of 75 patients were enrolled in the study,including 44 males and 31 females,aged 22-69 years with the average age of (48 ±9) years;40 patients (53.3％) were with normal oral glucose tolerance test,27 (36.0％) with prediabetes,and 8 (10.7％) with diabetes mellitus;57 patients (76.0％) were with hyperthyroidism,11 (14.7％) with hypothyroidism,and 7(9.3％)with normal thyroid function.The peak values of FBG and PBG in 75 patients during GPT treatment were significantly higher than those before the treatment [FBG:(7.9 ± 1.3) vs.(5.3 ± 1.2)mmol/L,PBG:(13.5±2.8) vs.(8.1 ±2.8) mmol/L;both P＜0.001],and the differences were (2.7 ± 1.0) and (5.4 ± 2.6) mmol/L,respectively (P ＜ 0.001).Among the 67 patients without diabetes mellitus,54 (80.6％) developed GIDM during GPT treatment.The levels of FBG and PBG in the 8 patients with diabetes mellitus increased by (2.7 ± 1.4) and (3.7 ± 2.5) mmol/L during GPT treatment,respectively.Multiple linear stepwise regression analysis showed that the influencing factors of FBG level during GPT treatment were baseline FBG level (P ＜ 0.001) and history of hyperuricemia (P =0.002) and dyslipidemia (P =0.032);the influencing factors of PBG level were baseline glycosylated hemoglobin A1c (HbA1c,P =0.002) level,baseline PGB level (P =0.024),and serum free thyroxine level (FT4,P =0.021).Conclusions GPT had a significant effect on blood glucose level in patients with GO,which could lead to higher incidence of GIDM.The main influencing factors of blood glucose level were baseline levels of FBG,PBG,and HbAlc,FT4 levels,and history of hyperuricemia and dyslipidemia.
