Patient's question:
Dad has had nephrotic syndrome for nine years and has been taking prednisone to control it. There was a period when his condition improved, but it has flared up again recently. His face has become swollen, he often experiences leg pain, and his mood is irritable and restless. He has also developed tension headaches recently. He wonders if it's related to the side effects of hormones. Now he wants to gradually reduce the hormones and seek traditional Chinese medicine treatment with herbal medicine. He currently takes six pills of prednisone at a time, and his condition flares up repeatedly, with intermittent nephrotic syndrome. Will taking hormones again lead to side effects such as weight gain?Doctor's answer:
1. Glycogenolysis and Glycogenesis Inhibition: Glucocorticoids inhibit the aerobic hydrolysis and anaerobic glycolysis of glucose, enhancing glucose production while reducing glucose utilization, thereby lowering blood glucose levels.2. Protein Catabolism: Glucocorticoids promote protein catabolism and inhibit its synthesis, leading to a negative nitrogen balance. GCS can reduce the activity of protein catabolic enzymes, enhance protein catabolism in various tissues, and promote the conversion of amino acids in the liver into glucose and glycogen, thereby increasing protein synthesis.
3. Fat Catabolism: Glucocorticoids promote fat catabolism and inhibit its synthesis. They can activate subcutaneous adipose tissue lipase in the limbs, causing fat catabolism and rearrangement in the face, neck, and torso.
4. Long-term use of glucocorticoids may lead to adrenal insufficiency syndrome, including moon face, buffalo hump, and central obesity, where fat accumulation occurs in the torso, making the abdomen appear larger.