Abstract:

Ｏｂｊｅｃｔｉｖｅ：To investigate the incidence and risk factors of steroidinduced diabetes mellitus (SDM) in patients with primary nephrotic syndrome,who have started glucocorticoid therapy.
Ｍｅｔｈｏｄｏｌｏｇｙ：From January 2011 to December 2015, patients who were diagnosed as SDM were enrolled into this retrospective study and their clinical characteristics were investigated. According to whether or not with abnormal glucose metabolism after accepting glucocorticoid therapy, the patients were divided into three groups as SDM, impaired glucose regulation (IGR), and normal glucose metabolism (NGM). The risk factors of SDM were analyzed with logistic regression.
Ｒｅｓｕｌｔｓ：Among 2 281 cases, total of 671 patients presented abnormal glucose metabolism (AGM) after glucocorticoid therapy, including 142 cases of SDM. 817% of SDM was diagnosed within the first year of glucocorticoid therapy, and the median time was 108 days. AGM was associated with age, focal segmental glomerulosclerosis, glomerular filtration rate and fasting plasma glucose (FPG). Significant statistical differences were existed among the three groups. Compared with NGM, SDM patients had higher body mass index (BMI), higher proportion of stage 2 or 3 hypertension, higher proportion of combined use of tacrolimus and higher level of triglyceride (TG), and the differences were statistically significant. However, there was no significant difference compared with IGR.Multivariate logistic regression analysis revealed that sex, age, FPG, TG, initial dose of glucocorticoid and simultaneous use of tacrolimus were risk factors of SDM.
Ｃｏｎｃｌｕｓｉｏｎ：The incidence of abnormal glucose metabolism in patients with primary nephrotic syndrome who had started glucocorticoid therapy was high. Female, elder, higher level of FPG, TG, GC, and simultaneous use of tacrolimus can increase the risk of SDM.