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Corticosteroid inhalers associated with higher BMI

Corticosteroid inhalers appear to increase the risk for a higher BMI in adults. This correlation was strongest for women.

A link has also been shown between the use of these anti-inflammatory inhalers and metabolic syndrome in women. Metabolic syndrome is a medical term for a combination of conditions that increases the risk for type II diabetes and cardiovascular diseases. This has been shown for the first time by research conducted by Erasmus MC.

Unexpected
Although further research will be necessary, and no direct causal relationship has been demonstrated yet, there are strong indications that the corticosteroid inhalers have these unexpected side effects for women. However, the researchers emphasize that women should not stop using their medication. "These findings suggest that corticosteroid inhalers have a greater impact on the body than was previously thought," says research physician Mesut Savas.

Professor Liesbeth van Rossum, internist-endocrinologist and head researcher at Erasmus MC's Center for Healthy Weight says "If further research confirms this finding, it would be necessary to focus more on the side effects and consider a better balance between side effects and the intended therapeutic effect. Particularly in women with an increased risk for metabolic syndrome."

Hogere BMI bij vrouwen door inhalatorEvidence
Corticosteroids are frequently used as anti-inflammatories. The inhaled forms of these anti-inflammatories are often used to treat asthma and other lung diseases. Until recently it was assumed that corticosteroids are most likely to cause side effects when injected or taken orally, as a prednisone course for example. Researchers have now found strong evidence that corticosteroids also cause these side effects when used in specific areas of the body, especially in the lungs.

Savas and Van Rossum conducted research on the use of corticosteroids among more than 140,000 participants of the Lifelines population study, a long-running study in the north of the Netherlands.  As many as one in ten participants used a drug that contains corticosteroids. The study showed that the BMI in women using inhalers was almost a point higher and that they also have a larger waist size than non-users.

Metabolic syndrome
Furthermore, the likelihood of developing high blood pressure, higher blood sugar values, higher blood lipid levels, and  less good cholesterol levels (that together form the metabolic syndrome) is higher, particularly in women, in this study.

Date published: 4 April 2017.

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