title: Effects of short-term oral corticosteroid intake on dietary intake, body weight and body composition in adults with asthma - a randomized controlled trial.
abstract: BACKGROUND
  Oral corticosteroids (OCS) are an efficacious treatment for asthma exacerbations, yet risk of adverse effects may decrease patient adherence to therapy. In particular, changes in appetite and dietary intake, which lead to weight gain and changes in body composition, are considered undesirable.
  
  
  OBJECTIVE
  To determine whether 10-day OCS therapy in adults with asthma causes changes in leptin, appetite, dietary intake, body weight and body composition.
  
  
  METHODS
  Double-blinded, placebo-controlled randomized cross-over trial of 10 days prednisolone (50 mg) in adults with stable asthma (n = 55) (ACTRN12611000562976). Pre- and post-assessment included spirometry, body weight, body composition measured by dual-energy X-ray absorptiometry and bioelectrical impedance analysis, appetite measured using a validated visual analogue scale (VAS) and dietary intake assessed using 4-day food records. Leptin was measured as a biomarker of appetite and eosinophils as an adherence biomarker. Outcomes were analysed by generalized linear mixed models.
  
  
  RESULTS
  Subject adherence was confirmed by a significant decrease in blood eosinophils (× 10(9) /L) following prednisolone compared to placebo [Coef. -0.29, 95% CI: (-0.39, -0.19) P < 0.001]. There was no difference in serum leptin (ng/mL) [Coef. 0.13, 95% CI: (-3.47, 3.72) P = 0.945] or appetite measured by VAS (mm) [Coef. -4.93, 95% CI: (-13.64, 3.79) P = 0.267] following prednisolone vs. placebo. There was no difference in dietary intake (kJ/day) [Coef. 255, 95% CI: (-380, 891) P = 0.431], body weight (kg) [Coef. -0.38, 95% CI: (-0.81, 0.05) P = 0.083] or body fat (%) [Coef. -0.31, 95% CI: (-0.81, 0.20) P = 0.230]. Symptoms including sleep and gastrointestinal disturbance were reported significantly more often during prednisolone vs. placebo.
  
  
  CONCLUSIONS
  Short-term OCS in stable asthma did not induce significant changes in appetite, dietary intake, body weight or composition, although other adverse effects may require medical management. This evidence may assist in increasing medication adherence of asthmatics prescribed OCS for exacerbations.
authors: Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
authors: B S
authors: BS
authors: Berthon
authors: Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
authors: P G
authors: PG
authors: Gibson
authors: School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
authors: P
authors: P
authors: McElduff
authors: School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia.
authors: L K
authors: LK
authors: MacDonald-Wicks
authors: Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
authors: L G
authors: LG
authors: Wood
mesh_terms: D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D001066:Appetite / Q000187:drug effects*; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D001823:Body Composition / Q000187:drug effects*; D001835:Body Weight / Q000187:drug effects*; D001837:Body Weights and Measures; D018592:Cross-Over Studies; D004804:Eosinophils; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D020738:Leptin
keywords: appetite; asthma; corticosteroids; diet; leptin