Carolyn J Petersons1, Brenda L Mangelsdorf2, Anne Poljak3, Malcolm D Smith4, Jerry R Greenfield5, Campbell H Thompson6, Morton G Burt7. 1. School of Medicine, Flinders University, Adelaide, Australia; Southern Adelaide Diabetes & Endocrine Services, Repatriation General Hospital, Adelaide, Australia. 2. Southern Adelaide Diabetes & Endocrine Services, Repatriation General Hospital, Adelaide, Australia. 3. Bioanalytical Mass Spectrometry Facility, Center for Healthy Brain Ageing and School of Medical Sciences, University of New South Wales, Sydney, Australia. 4. Department of Rheumatology, Repatriation General Hospital, Adelaide, Australia. 5. Diabetes and Obesity Research Program, Garvan Institute of Medical Research, Sydney, Australia; Department of Endocrinology, St Vincent's Hospital, Sydney, Australia. 6. School of Medicine, Flinders University, Adelaide, Australia; Discipline of Medicine, University of Adelaide, Adelaide, Australia. 7. School of Medicine, Flinders University, Adelaide, Australia; Southern Adelaide Diabetes & Endocrine Services, Repatriation General Hospital, Adelaide, Australia. Electronic address: morton.burt@sa.gov.au.
Abstract
BACKGROUND AND AIMS: Glucocorticoids could impair vascular function directly, or indirectly by reducing insulin sensitivity. The aim of this study was to determine the direct and indirect effects of acute and chronic low dose prednisolone on arterial stiffness and endothelial function. METHODS: Twelve subjects with inflammatory arthritis, who had not taken oral glucocorticoids for ≥6 months, and 12 subjects with inflammatory arthritis, taking chronic (>6 months) low dose (6.3 ± 2.2 mg/day) prednisolone, were studied. Patients not on glucocorticoids underwent measurement of arterial stiffness (pulse wave velocity (PWV)) and endothelial function (reactive hyperaemia index (RHI)) before and after 7-10 days of prednisolone (6 mg/day), to assess the acute effects of prednisolone. Baseline data from patients not on glucocorticoids were compared with patients on long-term prednisolone to assess the chronic effects of prednisolone. Hepatic insulin sensitivity was estimated from percentage suppression of endogenous glucose production and peripheral insulin sensitivity as glucose infusion rate (M/I) during a hyperinsulinaemic-euglycaemic clamp. RESULTS: There were no significant changes in PWV with acute (9.2 ± 0.8 vs. 8.9 ± 0.8 m/sec, p = 0.33) or chronic (8.9 ± 0.8 vs. 9.0 ± 0.7 m/sec, p = 0.69) prednisolone. In multiple regression analysis, PWV was negatively associated with M/I during hyperinsulinemic-euglycemic clamp (p = 0.02), but not with suppression of endogenous glucose production (p = 0.15) or glucocorticoid use (p = 0.70). Chronic (2.4 ± 0.2 vs. 1.9 ± 0.1, p = 0.02), but not acute (1.8 ± 0.2 vs. 1.9 ± 0.1, p = 0.24), prednisolone resulted in a higher RHI. CONCLUSIONS: Arterial stiffness is not affected by low dose prednisolone per se, but is negatively associated with peripheral insulin sensitivity. Patients with rheumatoid arthritis taking long-term prednisolone had better endothelial function.
BACKGROUND AND AIMS: Glucocorticoids could impair vascular function directly, or indirectly by reducing insulin sensitivity. The aim of this study was to determine the direct and indirect effects of acute and chronic low dose prednisolone on arterial stiffness and endothelial function. METHODS: Twelve subjects with inflammatory arthritis, who had not taken oral glucocorticoids for ≥6 months, and 12 subjects with inflammatory arthritis, taking chronic (>6 months) low dose (6.3 ± 2.2 mg/day) prednisolone, were studied. Patients not on glucocorticoids underwent measurement of arterial stiffness (pulse wave velocity (PWV)) and endothelial function (reactive hyperaemia index (RHI)) before and after 7-10 days of prednisolone (6 mg/day), to assess the acute effects of prednisolone. Baseline data from patients not on glucocorticoids were compared with patients on long-term prednisolone to assess the chronic effects of prednisolone. Hepatic insulin sensitivity was estimated from percentage suppression of endogenous glucose production and peripheral insulin sensitivity as glucose infusion rate (M/I) during a hyperinsulinaemic-euglycaemic clamp. RESULTS: There were no significant changes in PWV with acute (9.2 ± 0.8 vs. 8.9 ± 0.8 m/sec, p = 0.33) or chronic (8.9 ± 0.8 vs. 9.0 ± 0.7 m/sec, p = 0.69) prednisolone. In multiple regression analysis, PWV was negatively associated with M/I during hyperinsulinemic-euglycemic clamp (p = 0.02), but not with suppression of endogenous glucose production (p = 0.15) or glucocorticoid use (p = 0.70). Chronic (2.4 ± 0.2 vs. 1.9 ± 0.1, p = 0.02), but not acute (1.8 ± 0.2 vs. 1.9 ± 0.1, p = 0.24), prednisolone resulted in a higher RHI. CONCLUSIONS: Arterial stiffness is not affected by low dose prednisolone per se, but is negatively associated with peripheral insulin sensitivity. Patients with rheumatoid arthritis taking long-term prednisolone had better endothelial function.
Authors: Nantia Othonos; Thomas Marjot; Conor Woods; Jonathan M Hazlehurst; Nikolaos Nikolaou; Riccardo Pofi; Sarah White; Ilaria Bonaventura; Craig Webster; Joanne Duffy; Thomas Cornfield; Ahmad Moolla; Andrea M Isidori; Leanne Hodson; Jeremy W Tomlinson Journal: J Clin Endocrinol Metab Date: 2020-09-01 Impact factor: 5.958
Authors: Arduino A Mangoni; Richard J Woodman; Matteo Piga; Alberto Cauli; Anna Laura Fedele; Elisa Gremese; Gian Luca Erre Journal: Front Cardiovasc Med Date: 2021-07-19