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- Title
Short-term metabolic effects of prednisone administration in healthy subjects.
- Authors
Kauh, E. A.; Mixson, L. A.; Shankar, S.; McCarthy, J.; Maridakis, V.; Morrow, L.; Heinemann, L.; Ruddy, M. K.; Herman, G. A.; Kelley, D. E.; Hompesch, M.
- Abstract
Aims: Supraphysiologic glucocorticoid activity is well established to cause impaired glucose tolerance and insulin resistance, yet no study has evaluated dose-dependent effects of low-dose prednisone during short-term oral administration. Methods: The objective of this study was to quantify the effects of daily 10 or 25 mg prednisone administration for one week on insulin sensitivity by employing a two-step hyperinsulinemic euglycemic glucose clamp (Step 1: insulin infusion = 20 mU/m2/min; Step 2: insulin infusion = 80 mU/m2/min) in healthy, lean males. The amount of glucose infused at steady-state to maintain stable blood glucose [90 mg/dl (4.95 mmol/l)] was used to calculate several indices of insulin sensitivity. Results: During Step 1 of the clamp, whole body glucose disposal ( M) was reduced by 35% (p = 0.003) and M/ I was reduced by 29% (p = 0.025) for 25 mg prednisone compared to placebo. No appreciable effect of 10 mg prednisone was observed. During Step 2, M was reduced by 33% (p = 0.001) and 15% (p = 0.006) for 25 and 10 mg prednisone compared to placebo; and M/ I ratio was reduced by 31% (p < 0.001) and 13% (p = 0.026), respectively. The insulin sensitivity index, S i, calculated as the quotient of augmentation of M/I between Step 1 and 2, was reduced by 35.3% (p < 0.01) and 23.5% (p < 0.05) for 25 and 10 mg prednisone, respectively. Conclusion: Administration of relatively low pharmacological doses of prednisone for one week impaired insulin sensitivity in a dose-dependent manner in healthy males. These observed changes in insulin sensitivity are likely to be clinically relevant, especially in individuals predisposed to develop glucose intolerance.
- Subjects
PREDNISONE; DRUG side effects; METABOLIC regulation; GLUCOCORTICOIDS; GLUCOSE intolerance; TYPE 2 diabetes treatment
- Publication
Diabetes, Obesity & Metabolism, 2011, Vol 13, Issue 11, p1001
- ISSN
1462-8902
- Publication type
Article
- DOI
10.1111/j.1463-1326.2011.01432.x