AN OBSERVATIONAL STUDY OF EFFECT ON LIPID PROFILE BY SHORT TERM USE OF LOW DOSE STEROID THERAPY IN COMMON ORTHOPAEDIC CONDITIONS

Maheshkumar Prajapati, Mohammed Sohail Siddiqui, Ravi Patel, Ronak Daglia, Abhinav Vatsa, Charchit Baurasi
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Abstract

Introduction:Corticosteroids, potent anti-inflammatory drugs used for decades, provide symptomatic relief but carry risks like infection and chronic conditions. Despite complications, theyre prescribed for orthopedic issues. Glucocorticoids influence lipid levels, with conflicting effects. Steroids are termed a double-edged sword. This study aims to assess lipid profile effects of short-term, low-dose steroid therapy in Orthopedics and Rheumatology, evaluating glucocorticoid therapy impact and investigating other effects on musculoskeletal patients. Materials and Methods:This prospective, non-randomized observational study was conducted, focusing on patients with orthopedic and rheumatological issues. Over 150 patients were included, selected through convenient sampling. Inclusion criteria involved patients aged 18-65 without dyslipidemia or cardiovascular conditions, while exclusion criteria included those with specific medical conditions or high BMI. Patients provided written informed consent before undergoing blood tests for lipid profile and blood sugar levels, with vital signs measured. They received Medrol 4 mg thrice daily for ten days, after which outcomes including lipid levels, blood sugar, and blood pressure were assessed. Results:At baseline, 88.67% had desirable cholesterol levels and 11.33% had borderline levels. At follow-up, 20.67% had borderline levels and 79.33% had desirable levels, a statistically significant difference. Mean cholesterol levels decreased from 169.16 ± 19.70 mg/dl to 161.11 ± 27.60 mg/dl, also significant. For triglycerides, 92.67% had normal levels at baseline, decreasing to 65.33% at follow-up, with mean levels increasing from 131.33 ± 6.97 mg/dl to 139.12 ± 23.88 mg/dl. HDL levels showed improvement, with 84.67% having desirable levels at baseline compared to 43.33% at follow-up, with mean levels increasing from 41.09 ± 5.13 mg/dl to 50.71 ± 4.21 mg/dl. LDL levels decreased from 132.43 ± 16.86 mg/dl to 122.59 ± 16.93 mg/dl, with significant changes in distribution. Conclusions:Short-term steroid use for orthopedic conditions affects lipid profiles: Total cholesterol, LDL, and TG rise significantly, countered by increased HDL, offering protection. Long-term effects on lipid profiles and cardiovascular risk require further study. Risk of avascular necrosis due to subtle lipid profile changes also warrants investigation.
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在常见骨科疾病中短期使用低剂量类固醇疗法对血脂状况影响的观察性研究
导语:皮质类固醇是一种强效抗炎药物,已使用了几十年,可缓解症状,但也存在感染和慢性病等风险。尽管存在并发症,但它们仍被用于治疗骨科疾病。糖皮质激素会影响血脂水平,但效果却相互矛盾。类固醇被称为一把双刃剑。本研究旨在评估骨科和风湿科短期、低剂量类固醇治疗对血脂的影响,评估糖皮质激素治疗的影响,并调查对肌肉骨骼患者的其他影响。材料与方法:这项前瞻性非随机观察研究主要针对骨科和风湿病患者。150 多名患者通过方便的抽样方式被纳入研究。纳入标准包括年龄在 18-65 岁之间、无血脂异常或心血管疾病的患者,排除标准包括患有特殊疾病或体重指数过高的患者。患者在接受血脂和血糖水平的抽血化验以及生命体征测量之前,都要提供书面知情同意书。他们接受了为期十天、每天三次、每次 4 毫克的 Medrol 治疗,之后对血脂水平、血糖和血压等结果进行了评估。结果:基线时,88.67%的人胆固醇水平达到理想水平,11.33%的人处于边缘水平。随访时,20.67%的人处于边缘水平,79.33%的人处于理想水平,差异具有统计学意义。平均胆固醇水平从 169.16 Ã'± 19.70 mg/dl 降至 161.11 Ã'± 27.60 mg/dl,差异也很显著。甘油三酯方面,92.67%的患者基线水平正常,随访时降至65.33%,平均水平从131.33 Ã'± 6.97 mg/dl 升至139.12 Ã'± 23.88 mg/dl。高密度脂蛋白水平有所改善,基线时84.67%的人达到理想水平,而随访时为43.33%,平均水平从41.09 Ã'± 5.13 mg/dl增至50.71 ± 4.21 mg/dl。低密度脂蛋白水平从132.43 Ã'± 16.86 mg/dl降至122.59 Ã'± 16.93 mg/dl,其分布也发生了显著变化。结论:短期使用类固醇治疗骨科疾病会影响血脂状况:总胆固醇、低密度脂蛋白和总胆固醇显著升高,而高密度脂蛋白的升高则抵消了这一影响,从而提供了保护。对血脂和心血管风险的长期影响还需进一步研究。由于血脂组合的微妙变化而导致血管性坏死的风险也值得研究。
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