title: Corticosteroid therapy increases HDL-cholesterol concentrations in patients with active sarcoidosis and hypoalphalipoproteinemia.
abstract: BACKGROUND
  We have previously reported that the decrease in high-density lipoprotein (HDL)-cholesterol that is observed in patients with untreated sarcoidosis is limited to those with active disease.
  
  
  OBJECTIVE
  To determine the effect of corticosteroids, used in the treatment of active sarcoidosis, on the reported lipoprotein metabolism abnormalities.
  
  
  METHODS
  We studied 62 patients with biopsy-proven sarcoidosis, all of them with active disease. Sarcoidosis activity was evaluated by means of clinical, chest X-ray, gallium-67 scan, serum angiotensin-converting enzyme (peptidyl-dipeptidase A) values, and pulmonary function tests. A total of 40 patients were not treated with prednisone and 22 patients were treated with prednisone. The mean daily prednisone dosage in the treated patients with sarcoidosis was 20 mg and the mean duration of prednisone therapy was 6 months. Analysis of lipoprotein metabolism included: serum cholesterol, low-density lipoprotein (LDL)-cholesterol, HDL-cholesterol, HDL(2)-cholesterol, HDL(3)-cholesterol, apolipoprotein (apo) A-I, apo B, and triglyceride concentrations.
  
  
  RESULTS
  When patients with active sarcoidosis not treated with prednisone were compared to those treated with prednisone, the former had significantly lower HDL-cholesterol (1.17+/-0.36 vs. 1.42+/-0.42 mmol/l; P=0.01) and HDL(2)-cholesterol (0.37+/-0.18 vs. 0.53+/-0.25 mmol/l; P=0.009) levels. Multiple regression analysis demonstrated that the HDL-cholesterol (P=0.004), HDL(2)-cholesterol (P=0.002), HDL(3)-cholesterol (P=0.02), and apo A-I (P=0.02) levels were the variables independently and significantly associated with steroid therapy.
  
  
  CONCLUSIONS
  Corticosteroid therapy, used in the treatment of active sarcoidosis, increased HDL-cholesterol levels to those seen in inactive disease. These changes are manifestations of reducing disease activity.
authors: Internal Medicine Service, University of Barcelona, Ciutat Sanitària i Universitària de Bellvitge, C/ Consell de Cent, 218, 3o 1a, 08011 Barcelona, Spain. asalazar@csub.scs.es
authors: Albert
authors: A
authors: Salazar
authors: Juan
authors: J
authors: Mañá
authors: Xavier
authors: X
authors: Pintó
authors: Josep Ma
authors: JM
authors: Argimón
authors: Isabel
authors: I
authors: Hurtado
authors: Ramon
authors: R
authors: Pujol
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D008076:Cholesterol, HDL / Q000097:blood* / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000494:pharmacology* / Q000627:therapeutic use; D012507:Sarcoidosis / Q000097:blood / Q000188:drug therapy*
chemical_list: D000893:Anti-Inflammatory Agents; D008076:Cholesterol, HDL; D011241:Prednisone