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van Raalte, D.H. et al.

Daniël H. van Raalte, Valentina Nofrate, Mathijs C. Bunck, Thijs van Iersel, Jeroen Elassaiss Schaap, Ulla K. Nässander, Robert J. Heine, Andrea Mari, Wim H. A. Dokter, Michaela Diamant,

Acute and 2-week exposure to prednisolone impair different aspects of beta-cell function in healthy men.

OBJECTIVE: Glucocorticoids (GCs), such as prednisolone, are associated with adverse metabolic effects, including glucose intolerance and diabetes. In contrast to the well known GC-induced insulin resistance, the effects of GCs on beta-cell function are less well established. We assessed the acute and short-term effects of prednisolone treatment on beta-cell function in healthy men. RESEARCH DESIGN AND METHODS: A randomised, double-blind, placebo-controlled trial consisting of two protocols was conducted. In protocol 1 (n=6), placebo and a single dose of 75 mg of prednisolone were administered. In protocol 2 (n=23), participants received 30 mg of prednisolone daily or placebo for 15 days. Both empirical and model-based parameters of beta-cell function were calculated from glucose, insulin and C-peptide concentrations obtained during standardised meal tests before and during prednisolone treatment (protocols 1 and 2), and 1 day after cessation of treatment (protocol 2). RESULTS: Seventy-five milligrams of prednisolone acutely increased the area under the postprandial glucose curve (AUC(gluc); P=0.005), and inhibited several parameters of beta-cell function, including AUC(c-pep)/AUC(gluc) ratio (P=0.004), insulinogenic index (P=0.007), glucose sensitivity (P=0.02) and potentiation factor ratio (PFR; P=0.04). A 15-day treatment with prednisolone increased AUC(gluc) (P<0.001), despite augmented C-peptide secretion (P=0.05). beta-cell function parameters were impaired, including the fasting insulin secretory tone (P=0.02) and PFR (P=0.007). CONCLUSIONS: Acute and short-term exposure to prednisolone impairs different aspects of beta-cell function, which contribute to its diabetogenic effects.[1]

References

Acute and 2-week exposure to prednisolone impair different aspects of beta-cell function in healthy men. van Raalte, D.H., Nofrate, V., Bunck, M.C., van Iersel, T., Elassaiss Schaap, J., Nässander, U.K., Heine, R.J., Mari, A., Dokter, W.H., Diamant, M. Eur. J. Endocrinol. (2010) [Pubmed]

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