Corticosteroid Effects

Metabolic Effects

The use of glucocorticoids is associated with an increase in appetite, resistance to insulin at the hepatic level, catabolic effects that mobilize amino acids from bone and muscle for hepatic gluconeogenesis, and central deposition of adipose tissue, according to the American College of Rheumatology 1
Glucocorticoids have anti-inflammatory and metabolic effects that affect various systems, including the inhibition of osteoblasts and osteocytes, reducing bone formation, and stimulation of osteoclasts, increasing bone resorption, as stated by the European Society for Medical Oncology 2

Glucocorticoids inhibit osteoblasts and osteocytes, reducing bone formation, and stimulate osteoclasts, increasing bone resorption, which can lead to a decrease in bone mass, as reported by the European Society for Medical Oncology 2
The use of glucocorticoids is associated with a reduction in the absorption of vitamin D, a decrease in calcium reabsorption, and an increase in 24-hydroxylase activity, which can contribute to bone loss, according to the European Society for Medical Oncology 2

Glucocorticoids can cause a delay in linear growth in children, as stated by the European League Against Rheumatism 3
The use of glucocorticoids in children requires regular monitoring of linear growth and consideration of growth hormone replacement in case of growth alteration, as recommended by the European League Against Rheumatism 3

The adverse effects of glucocorticoids are more significant with daily doses equivalent to >5 mg of prednisolone, and the risk of adverse effects increases exponentially with the daily dose, according to the American College of Rheumatology 1
The duration of treatment is important, as short-term therapy may increase energy intake without weight gain, while long-term therapy results in clinically significant weight gain, as reported by the American College of Rheumatology 1