Risk of diabetes mellitus among patients with myasthenia gravis

Yeh, Jiann‐Horng; Chen, H. J.; Lin, Cheng‐Chieh; Chen, Y. K.; Chiu, Hou‐Chang; Kao, Chia‐Hung

doi:10.1111/ane.12374

Cited by 14 publications

(14 citation statements)

References 18 publications

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“…Detailed prevalence reports of association of diabetes mellitus with MG are lacking, but it is estimated to be 2–3% [ 32 ], [ 33 ]. According to a Taiwanese study, MG cohort had a 1.26-fold increased risk of developing DM compared with the comparison cohort [ 34 ]. Our study proves that refractory MG patients are associated with higher risk of diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab

Sudulagunta

Sepehrar

Sodalagunta

et al. 2016

GMS German Medical Science; 14:Doc12

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Section: Discussionmentioning

confidence: 99%

Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab

Sudulagunta

Sepehrar

Sodalagunta

et al. 2016

GMS German Medical Science; 14:Doc12

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“…[ 18 ] In a population-based cohort study in Taiwan, there is 1.26-fold risk of diabetes mellitus (hazard ratio [HR] =1.26, 95% confidence interval [CI] = 1.04–1.53). [ 19 ] The risk is higher in patients with corticosteroids use (HR = 1.46, 95% CI = 1.15–1.86). MG is also associated with a higher risk of osteoporosis regardless of corticosteroid use (HR = 1.96, 1.52 in corticosteroid-naïve patients, 2.37 in corticosteroid-treated patients, 95% CI = 1.57–2.44, 1.11–2.08 in corticosteroid-naïve patients, 1.82–3.07 in corticosteroid-treated patients).…”

Section: Epidemiology and Background Characteristics In Taiwanmentioning

confidence: 99%

Update on ocular myasthenia gravis in Taiwan

Lin

Chen

Jou

et al. 2018

Taiwan J Ophthalmol

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Myasthenia gravis (MG) is an autoimmune disease involving the neuromuscular junction. Autoantibodies to the acetylcholine receptor or, less frequently, to muscle-specific kinase, attack against the postsynaptic junctional proteins, resulting in fluctuating and variable weakness of muscles. Extraocular, levator palpebrae superioris, and orbicularis oculi muscles are particularly susceptible. The majority of patients with MG present with purely ocular symptoms including ptosis and diplopia initially. About half of these patients progress to generalized disease within 2 years. The prevalence of MG in Taiwan is 140 per million with male to female ratio of 0.7. The incidence rate is higher in the elderly. Several immune-related diseases such as lymphoid malignancy, diabetes, and thyroid diseases are associated with MG in the national population-based studies in Taiwan. Ice pack test, rest test, Tensilon/neostigmine test, circulating antibody measurement, and electrophysiological studies are useful diagnostic tools with variable sensitivity and specificity. For the patients with ocular MG, acetylcholinesterase inhibitors are usually the first-line treatment. Corticosteroids and immunosuppressant could provide better disease control and may reduce the risk of conversion to generalized form although there is still some controversy. A thymectomy is also beneficial for ocular MG, especially in refractory cases. The correction of ptosis and strabismus surgery could improve the visual outcome but should be performed only in stable disease.

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“…Braz et al demonstrated that a high cumulative corticosteroid dose in patients with MG could cause increased body fat and decreased lean body mass [25]. Corticosteroid use has several side effects, including weight gain, central obesity, and increased adiposity, and long-term corticosteroid use by patients with MG can also result in metabolic consequences, such as insulin resistance and diabetes [26]. However, in contrast to previous results, our study showed that body composition changes in fat adiposity and muscle mass were not associated with corticosteroid use but were possibly related to the disease severity and progression.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study

Chang

Chen

Chiu

et al. 2021

JPM

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Sarcopenia and obesity can negatively impact quality of life and cause chronic fragility, and are associated with neuromuscular diseases, including myasthenia gravis (MG). The long-term consequences of body composition changes in chronic MG remain unknown; we therefore evaluated changes in body composition, including sarcopenia, obesity, lean body mass, and the prevalence of sarcopenic obesity in patients. In this cross-sectional study, 35 patients with MG (mean age: 56.1 years) and 175 matched controls were enrolled. Body fat mass and skeletal muscle mass were measured using whole body dual-energy X-ray absorptiometry. Patients with MG exhibited a higher prevalence of obesity and higher android adiposity and total body fat percentage than those of controls. Although the prevalence of sarcopenia and sarcopenic obesity did not increase with age, there was a decrease in arm and android muscle mass in patients with MG compared with controls. Lower muscle mass percentages were correlated with increased age and MG severity, but not with corticosteroid use. Thus, MG is associated with increased risk for obesity and decreased muscle mass with aging, regardless of corticosteroid use. Therefore, accurate diagnosis of body composition changes in MG could facilitate the application of appropriate therapies to promote health, improve quality of life, and prevent fragility.

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Risk of diabetes mellitus among patients with myasthenia gravis

Abstract: This population-based retrospective cohort study demonstrates that MG is associated with a high risk of DM, which might be related to the adverse effect of corticosteroid and aggressive therapy.

Cited by 14 publications

References 18 publications

Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab

Refractory myasthenia gravis – clinical profile, comorbidities and response to rituximab

Update on ocular myasthenia gravis in Taiwan

Assessment of Sarcopenia and Obesity in Patients with Myasthenia Gravis Using Dual-Energy X-ray Absorptiometry: A Cross-Sectional Study

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