Incidence and risk factors for corticosteroid-induced lipodystrophy: a prospective study

J Am Acad Dermatol. 2007 Oct;57(4):604-9. doi: 10.1016/j.jaad.2007.04.018. Epub 2007 Jun 19.


Background: Very few studies have focused on fat redistribution induced by corticosteroids.

Objective: To establish the incidence and risk factors of facial ("moon face") and cervical ("buffalo hump") lipodystrophy due to long-term (> or =3 months), high dosage (>or =20 mg/d) systemic corticosteroid therapy.

Methods: Between June 2003 and May 2005 we conducted a prospective study in two French tertiary centers. All consecutive patients starting long-term systemic corticosteroid therapy at an initial daily dosage of 20 mg or more were enrolled in this study. Three investigators assessed the development of facial and cervical corticosteroid-induced lipodystrophy (CIL) from standardized photographs. Demographic, clinical, and nutritional data were examined to assess risk factors of CIL.

Results: Eighty-eight patients were enrolled (women: 75%, mean age: 57.4 +/- 17.9 years, mean baseline dosage of prednisone: 56 +/- 15 mg/d). The cumulative incidence rate of CIL at months 3 and 12 was 61% +/- 8% and 69% +/- 9%, respectively. In multivariate analyses the risk of CIL at the third month was higher in women (odds ratio [OR]: 10.87 [2.43-58.82]), in subjects younger than 50 years of age (OR: 11.11 [2.19-37.89]), in subjects with a high initial body mass index (OR: 1.56 [1.21-2.03] per increment of 1 kg/m2) and in subjects with high energy intake (OR: 6.11 [1.35-27.75] when higher than 30 kcal/d/kg).

Limitations: Photographic analysis is not a conventional method for the diagnosis of CIL.

Conclusion: CIL frequently occurs, especially in overweight subjects and in women, who are also at higher risk to develop other forms of lipodystrophies.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Female
  • Glucocorticoids / adverse effects*
  • Humans
  • Incidence
  • Lipodystrophy / chemically induced*
  • Lipodystrophy / diagnosis
  • Lipodystrophy / epidemiology
  • Male
  • Middle Aged
  • Photography
  • Prospective Studies
  • Risk Factors


  • Glucocorticoids