title: Effects of inhaled budesonide on serum markers of bone metabolism in children with asthma.
abstract: The effects of inhaled glucocorticoids on serum markers of bone formation were evaluated in asthmatic children. Serum total alkaline phosphatase (AP), bone alkaline phosphatase (BAP), osteocalcin, and the novel marker of bone formation, carboxypropeptide of type I procollagen (PICP), were measured. In the cross-sectional part, long-term glucocorticoid users were compared with sodium cromoglycate (SCG) users. In the boys (n = 16), but not in the girls (n = 11), PICP was significantly lower in the glucocorticoid users than in the SCG users. PICP correlated positively with BAP (n = 54; groups combined, r = 0.29, p < 0.05). In the longitudinal part, the effects of inhaled budesonide or SCG, both used for the first time, were evaluated before and after 1 and 5 months of treatment. The budesonide dose was 800 micrograms/m2/day for 1 month and thereafter half of that. The SCG dose was 30 mg/day throughout the study. Only during budesonide use did osteocalcin and PICP decrease, the median osteocalcin by 8% at 1 month (p < 0.05) and by 6% at 5 months (n = 15), and PICP by 5% at 1 month (p < 0.05) and by 28% at 5 months (n = 7, p < 0.01). AP and BAP did not change significantly. Decreased PICP suggests decreased bone formation rate. PICP might be clinically useful as a marker of early adverse effects of glucocorticoids on bone.
authors.affiliation: Department of Allergic Diseases, Helsinki University Central Hospital, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Sorva
authors.forename: M
authors.initials: M
authors.lastname: Turpeinen
authors.forename: K
authors.initials: K
authors.lastname: Juntunen-Backman
authors.forename: S L
authors.initials: SL
authors.lastname: Karonen
authors.forename: A
authors.initials: A
authors.lastname: Sorva
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood; D001249:Asthma / Q000378:metabolism*; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism*; D019819:Budesonide; D002118:Calcium / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004205:Cromolyn Sodium / Q000494:pharmacology; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011282:Pregnenediones / Q000494:pharmacology*; D011347:Procollagen / Q000097:blood
chemical_list: D005938:Glucocorticoids; D010446:Peptide Fragments; D011282:Pregnenediones; D011347:Procollagen; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; D019819:Budesonide; D007334:Insulin-Like Growth Factor I; D000469:Alkaline Phosphatase; D004205:Cromolyn Sodium; D002118:Calcium