Steroid use and lipid abnormalities in children: assessing the risk in chronic disease management

Introduction : Although steroid-induced dyslipidemia is well-documented in adults, its impact on children remains underexplored. Given the long-term cardiovascular risks associated with dyslipidemia, understanding its link with steroid use in children is crucial. Aim : This study aimed to evaluate the association of steroid therapy, specifically its dose, duration, and type with the development of dyslipidemia in children with chronic diseases. Materials and methods : A retrospective cross-sectional study was conducted from January 2022 to January 2024 in a tertiary hospital in Medan, Indonesia. Medical records of children receiving steroid therapy for at least six weeks were reviewed. Steroid doses were converted to prednisone equivalents. Dyslipidemia was defined according to the Expert Panel Guidelines. Data distribution was assessed using normality tests and appropriate statistical tests were selected based on the distribution of each variable. Results : The study included 63 children, 54 (85.7%) of whom had dyslipidemia. A significant association was found between higher steroid dose and dyslipidemia ( p =0.002), especially for LDL and total cholesterol levels ( p =0.005 and p =0.017, respectively). Although the association between dyslipidemia and steroid duration was borderline ( p =0.050), children treated for 6–24 weeks exhibited significantly higher LDL ( p =0.035) and total cholesterol ( p =0.010) compared to those treated longer. No significant differences in lipid parameters were observed across steroid types. Conclusion : Steroid use in children with chronic diseases is significantly associated with dyslipidemia. A higher steroid dose was associated with abnormal lipid profiles. These findings support the recommendation for routine lipid monitoring and careful dose consideration to help mitigate long-term cardiovascular risk.