title: The influence of glucocorticoids on lipid and lipoprotein metabolism and atherosclerosis.
abstract: Glucocorticoids have multiple therapeutic uses, but their impact on lipid metabolism and cardiovascular disease risk is not always considered during long-term treatment. Genetic variations, environmental factors and the reasons for glucocorticoid treatment all influence the lipid profile and atherosclerosis. Responses to glucocorticoid treatment may therefore be variable and unpredictable. Despite the frequency with which pharmacological doses of glucocorticoids are used, surprisingly few publications examine their effects on lipid metabolism and atherosclerosis. Patients managed with glucocorticoids should have their cardiovascular risk assessed, especially if long-term treatment is planned. While some apparent favourable changes have been reported in high-density lipoprotein metabolism, very-low-density lipoprotein and low-density lipoprotein responses seem unfavourable. The impact of glucocorticoids on atherosclerosis, which is often viewed as an inflammatory process, is unclear. Glucocorticoid treatment should be undertaken for appropriate indications, but in some instances special attention should be given to management of dyslipidaemia, as long-term survivors of treatment are likely to encounter atherosclerosis.
authors.affiliation: Division of Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa, and Groote Schuur Hospital, Cape Town; South Africa. ian.ross@uct.ac.za.
authors.forename: Ian L
authors.initials: IL
authors.lastname: Ross
authors.forename: A David
authors.initials: AD
authors.lastname: Marais
mesh_terms: D050197:Atherosclerosis / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D016903:Drug Monitoring; D005938:Glucocorticoids / Q000009:adverse effects / Q000378:metabolism; D006801:Humans; D050356:Lipid Metabolism / Q000187:drug effects*; D008074:Lipoproteins / Q000097:blood*; D010347:Patient Care Planning; D018570:Risk Assessment; D012307:Risk Factors; D013995:Time
chemical_list: D005938:Glucocorticoids; D008074:Lipoproteins