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Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?

OBJECTIVES: The use of long-term corticosteroids during pregnancy has been growing over the past decades. Corticosteroids can be given when an auto-inflammatory disease like rheumatoid arthritis (RA) is too active. Several studies have shown that long-term corticosteroids use in pregnancy is associa...

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Autores principales: de Steenwinkel, Florentien D. O., Dolhain, Radboud J. E. M., Hazes, Johanna M. W., Hokken-Koelega, Anita C. S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9823030/
https://www.ncbi.nlm.nih.gov/pubmed/36040672
http://dx.doi.org/10.1007/s10067-022-06347-0
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author de Steenwinkel, Florentien D. O.
Dolhain, Radboud J. E. M.
Hazes, Johanna M. W.
Hokken-Koelega, Anita C. S.
author_facet de Steenwinkel, Florentien D. O.
Dolhain, Radboud J. E. M.
Hazes, Johanna M. W.
Hokken-Koelega, Anita C. S.
author_sort de Steenwinkel, Florentien D. O.
collection PubMed
description OBJECTIVES: The use of long-term corticosteroids during pregnancy has been growing over the past decades. Corticosteroids can be given when an auto-inflammatory disease like rheumatoid arthritis (RA) is too active. Several studies have shown that long-term corticosteroids use in pregnancy is associated with maternal and fetal adverse outcomes, like preeclampsia, shorter gestational age, lower birth weight, and rapid catch-up growth. These last two outcomes could influence the insulin resistance later in life. Our objective was to investigate whether prednisone use in pregnant women with RA induces insulin resistance in offspring. METHODS: One hundred three children were included after their mother had participated in a prospective cohort study on RA and pregnancy. Forty-two children were in utero exposed to prednisone and 61 were non-exposed. To assess insulin resistance, we measured homeostasis model of assessment insulin resistance (HOMA-IR) and serum adiponectin and lipid levels, corrected for body fat distribution. RESULTS: An average of 6 mg prednisone on a daily use gave no difference in mean HOMA-IR (SD) between the children who were prednisone-exposed in utero (1.10 (0.84)) and those non-exposed (1.09 (0.49)). No difference was found in mean adiponectin level, body fat distribution, or lipid levels such as total cholesterol, fasting triglyceride, or high-density lipoprotein. CONCLUSION: Children who are prednisone-exposed in utero (low dose) have no increased risk for insulin resistance at the age of approximately 7 years. These findings are reassuring because the prednisone use during pregnancy is increasing worldwide. Further research has to be performed to evaluate if the insulin resistance remains absent in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10067-022-06347-0.
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spelling pubmed-98230302023-01-08 Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring? de Steenwinkel, Florentien D. O. Dolhain, Radboud J. E. M. Hazes, Johanna M. W. Hokken-Koelega, Anita C. S. Clin Rheumatol Original Article OBJECTIVES: The use of long-term corticosteroids during pregnancy has been growing over the past decades. Corticosteroids can be given when an auto-inflammatory disease like rheumatoid arthritis (RA) is too active. Several studies have shown that long-term corticosteroids use in pregnancy is associated with maternal and fetal adverse outcomes, like preeclampsia, shorter gestational age, lower birth weight, and rapid catch-up growth. These last two outcomes could influence the insulin resistance later in life. Our objective was to investigate whether prednisone use in pregnant women with RA induces insulin resistance in offspring. METHODS: One hundred three children were included after their mother had participated in a prospective cohort study on RA and pregnancy. Forty-two children were in utero exposed to prednisone and 61 were non-exposed. To assess insulin resistance, we measured homeostasis model of assessment insulin resistance (HOMA-IR) and serum adiponectin and lipid levels, corrected for body fat distribution. RESULTS: An average of 6 mg prednisone on a daily use gave no difference in mean HOMA-IR (SD) between the children who were prednisone-exposed in utero (1.10 (0.84)) and those non-exposed (1.09 (0.49)). No difference was found in mean adiponectin level, body fat distribution, or lipid levels such as total cholesterol, fasting triglyceride, or high-density lipoprotein. CONCLUSION: Children who are prednisone-exposed in utero (low dose) have no increased risk for insulin resistance at the age of approximately 7 years. These findings are reassuring because the prednisone use during pregnancy is increasing worldwide. Further research has to be performed to evaluate if the insulin resistance remains absent in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10067-022-06347-0. Springer International Publishing 2022-08-30 2023 /pmc/articles/PMC9823030/ /pubmed/36040672 http://dx.doi.org/10.1007/s10067-022-06347-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
de Steenwinkel, Florentien D. O.
Dolhain, Radboud J. E. M.
Hazes, Johanna M. W.
Hokken-Koelega, Anita C. S.
Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
title Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
title_full Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
title_fullStr Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
title_full_unstemmed Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
title_short Does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
title_sort does prednisone use in pregnant women with rheumatoid arthritis induce insulin resistance in the offspring?
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9823030/
https://www.ncbi.nlm.nih.gov/pubmed/36040672
http://dx.doi.org/10.1007/s10067-022-06347-0
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