Journal de la grossesse et de la santé infantile

Abstrait

Glucocorticoid-Induced Insulin Resistance and Its Intervention in Children with Refractory Nephrotic Syndrome

Li Zhang, Na Li, Li Song, Wanqi Zheng, Yong Li Zhao and Zhengjuan Liu

The side effects of glucocorticoid-induced insulin resistance (IR) have drawn increasing attention, but the information is scarce regarding treatment of glucocorticoid-induced insulin resistance in children. The study was conducted in children who received prolonged high-dose glucocorticoid for refractory nephrotic syndrome. The Body Mass Index (BMI) was monitored and metabolic parameters were determined. Homeostatic model assessment for insulin resistance index (HOMA-IR) was used for assessing glucocorticoid-induced IR. There were 41 obese children with HOMA-IR>3.5. The HOMA-IR showed a positive correlation with prednisone dosage, LDL-C, age and BMI (P<0.01), respectively. Multiple linear regression analysis showed that prednisone dosage, LDL-C, age and BMI correlated independently with HOMA-IR (P<0.05). Twenty-one children received metformin therapy as treated group and 20 patients received placebo as control group. After 3 months of treatment, the BMI and IR were significantly improved and the BMI and HOMA-IR were also significantly reduced compared to the control group. No significant toxicity from metformin was seen. Metformin is safe and effective for treatment of glucocorticoid-induced obesity and IR.