Lifestyle Characteristics of Children with Glucocorticoid-Induced Weight Gain and Children with Simple Obesity

BACKGROUND: Lifestyle influences the risk of childhood obesity. Long-term use of glucocorticoids (GCS) for treatment of chronic autoimmune and inflammatory diseases in children leads to development of obesity with Cushing redistribution of subcutaneous fat; spontaneous weight normalization is expected after dose reduction or discontinuation of GCS. However, in some cases obesity persists.
AIM: To study the lifestyle characteristics of children with weight gain during GCS therapy compared to children with simple obesity (SO)
MATERIALS AND METHODS: We compared the results of a questionnaire-based survey of children treated with GCS in 09.2017-03.2018 and the previous survey of patients with SO in 2015. We analyzed the follow-up of patients treated with GCS.
RESULTS: 25 patients (14 girls, 11 boys; 12.1 (9.4; 15.3) years) taking GCS at a maximum dose of 1.00 (0.50; 1.00) mg/kg/day, compared with 100 patients (43 girls, 57 boys; 13.4 (10.5; 15.7) years) with SO were characterized by significantly more sedentary lifestyle, adherence to breakfast and snacks. BMI SDS after 7.8 (3.2; 9.6) years of therapy correlated with BMI SDS before treatment and while maximum GCS dose treatment (p<0.01), but not with the value of maintenance dose of GCS (0.09 (0.00; 0.16) mg/kg/day). Persistence of obesity after reduction of the GCS dose was associated with the absence of any physical activity — OR 3.5 (95% CI 0.460–26.617).
CONCLUSION: Most children with chronic autoimmune and inflammatory diseases treated with GCS have a sedentary lifestyle, which is a risk factor for the persistence of obesity after reducing the dose of GCS.

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