Chinese Journal of Dermatology ›› 2014, Vol. 47 ›› Issue (6): 381-384.

• Original articles •     Next Articles

Glucocorticoid-induced diabetes mellitus in patients with pemphigus or pemphigoid: prevalence and risk factors

  

  • Received:2013-06-21 Revised:2014-02-17 Online:2014-06-15 Published:2014-06-01

Abstract: Sun Zufeng, Gu Ningyan, Zhou Min, Wen Zhihua, Chen Jingjing, Yao Xu. Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing 210042, China Corresponding author: Yao Xu, Email: dryao_xu@126.com 【Abstract】 Objective To investigate the prevalence of and risk factors for glucocorticoid-induced diabetes mellitus(GDM) in patients with pemphigus or pemphigoid receiving glucocorticoid therapy. Methods This study included 68 hospitalized patients with pemphigus or pemphigoid receiving glucocorticoid therapy in the Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from December 2011 to January 2013. Comparisons were carried out between patients with GDM and those without regarding multiple parameters, including age, sex, body mass index(BMI), pathological type, initial dose and maximum daily dose of glucocorticoids, family history of diabetes mellitus, immunosuppressive treatment, etc. Independent samples t test was used for intergroup comparisons, Chi-square test and Fisher exact probability test for the analysis of count data, and a logistic regression model for the determination of risk factors. Results Among the 68 patients, 26 (38.2%) developed GDM during glucocorticoid therapy. Univariate logistic regression analysis showed that the initial dose of glucocorticoids (P < 0.05, OR 1.023, 95% CI 1.002 - 1.044), maximum daily dose of glucocorticoids(P < 0.01, OR 1.037, 95% CI 1.013 - 1.062), duration of glucocorticoid treatment (P < 0.05, OR 1.143, 95% CI 1.028 - 1.271), BMI(P < 0.01, OR 1.265, 95% CI 1.080 - 1.481) and dexamethasone use(P < 0.01, OR 6.0, 95% CI 1.887 - 19.076) were risk factors for GDM in these patients. Multivariate logistic regression analysis showed that BMI(P < 0.05, OR 1.223, 95% CI 1.017 - 1.471) and maximum daily dose of glucocorticoids (P < 0.05, OR 1.037, 95% CI 1.009 - 1.065) were independent risk factors for GDM. Conclusions In this study, 38.2% of the patients with pemphigus or pemphigoid developed GDM during glucocorticoid therapy. BMI and maximum daily dose of glucocorticoids seem to be independent risk factors for GDM.

Key words: Pemphigus, Pemphigoid, bullous, Glucocorticoids, Diabetes mellitus

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