title: Glucocorticoid-related changes in body mass index among children and adolescents with rheumatic diseases.
abstract: OBJECTIVE
  To examine the temporal and dose-related effects of glucocorticoids (GCs) on body mass index (BMI) in children with rheumatic diseases.
  
  
  METHODS
  Children initiating GCs for a rheumatic disease (n = 130) were assessed every 3 months for 18 months. BMI, weight, and height Z score trajectories were described according to GC starting dosage in prednisone equivalents: high (≥1.0 mg/kg/day), low (<0.2 mg/kg/day to a maximum of 7.5 mg/day), and moderate (between high and low) dosage. The impact of GC dosing, underlying diagnosis, pubertal status, physical activity, and disease activity on BMI Z scores and on percent body fat was assessed with longitudinal mixed-effects growth curve models.
  
  
  RESULTS
  The GC starting dose was high in 59% and moderate in 39% of patients. The peak BMI Z score was +1.29 at 4 months with high-dose GCs and +0.69 at 4.2 months with moderate-dose GCs (P < 0.001). Overall, 50% (95% confidence interval 41-59%) of the children returned to within +0.25 SD of their baseline BMI Z score. Oral GC dose over the preceding 3 months was the most significant determinant of BMI Z score and percent body fat. The proportion of days in receipt of GCs, disease activity, and a diagnosis of systemic-onset juvenile idiopathic arthritis were also associated with BMI Z scores. The correlation between changes in BMI and changes in percent body fat was 0.09.
  
  
  CONCLUSIONS
  In children with rheumatic diseases starting moderate and high doses of GCs, BMI Z scores peaked at 4 months, and only half returned to within +0.25 SD of their baseline BMI Z score after 18 months.
authors: University of Saskatchewan, Saskatoon, Saskatchewan, Canada. natalie.shiff@usask.ca
authors: Natalie J
authors: NJ
authors: Shiff
authors: Rollin
authors: R
authors: Brant
authors: Jaime
authors: J
authors: Guzman
authors: David A
authors: DA
authors: Cabral
authors: Adam M
authors: AM
authors: Huber
authors: Paivimm
authors: P
authors: Miettunen
authors: Johannes
authors: J
authors: Roth
authors: Rosie
authors: R
authors: Scuccimarri
authors: Nathalie
authors: N
authors: Alos
authors: Stephanie A
authors: SA
authors: Atkinson
authors: Jean Paul
authors: JP
authors: Collet
authors: Robert
authors: R
authors: Couch
authors: Elizabeth A
authors: EA
authors: Cummings
authors: Peter B
authors: PB
authors: Dent
authors: Janet
authors: J
authors: Ellsworth
authors: John
authors: J
authors: Hay
authors: Kristin
authors: K
authors: Houghton
authors: Roman
authors: R
authors: Jurencak
authors: Bianca
authors: B
authors: Lang
authors: Maggie
authors: M
authors: Larche
authors: Claire
authors: C
authors: Leblanc
authors: Celia
authors: C
authors: Rodd
authors: Claire
authors: C
authors: Saint-Cyr
authors: Robert
authors: R
authors: Stein
authors: David
authors: D
authors: Stephure
authors: Shayne
authors: S
authors: Taback
authors: Frank
authors: F
authors: Rauch
authors: Leanne M
authors: LM
authors: Ward
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000188:drug therapy*; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone