ISSN: 2376-127X

Journal of Pregnancy and Child Health
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  • Research Article   
  • J Preg Child Health,
  • DOI: 10.4172/2376-127X.1000368

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

Li Zhang, Na Li, Li Song, Wanqi Zheng, Yong Li Zhao, Yong Li Zhao and Zhengjuan Liu*
Department of Paediatrics, Second Affiliated Hospital of Dalian Medical University, , China
*Corresponding Author : Zhengjuan Liu, Department of Paediatrics, Second Affiliated Hospital of Dalian Medical University, Shahekou District, Dalian, China, Tel: 041184671291, Fax: 041184672130, Email: liuzj625@163.com

Received Date: Feb 24, 2018 / Accepted Date: Mar 26, 2018 / Published Date: Apr 02, 2018

Abstract

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.

Keywords: Metformin; Obesity; Insulin resistance; Glucocorticoids; Children

Citation: Zhang L, Li N, Song L, Zheng W, Zhao YL, et al. (2018) Glucocorticoid- Induced Insulin Resistance and Its Intervention in Children with Refractory Nephrotic Syndrome. J Preg Child Health 5:368. Doi: 10.4172/2376-127X.1000368

Copyright: © 2018 Zhang L, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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