Longitudinal assessment of bone mineral density in children with chronic asthma.
BACKGROUND
With the emphasis on asthma as a chronic inflammatory process, the management of moderate to severe asthma, even in the pediatric population, has shifted to the regular use of inhaled anti-inflammatory agents, including inhaled corticosteroids. Accompanying the use of these agents has been the precaution that long-term use may have subtle or potential side effects, including growth suppression or decreased bone mineral deposition.


OBJECTIVE
We sought to study the effects of inhaled anti-inflammatory agents on bone mineral density accumulation in growing asthmatic children. Included in this report is the longitudinal acquisition of bone mineral density in children with moderate to severe asthma.


METHODS
Bone mineral density in normal and asthmatic children was measured longitudinally by dual-energy absorptiometry. Bone densitometry was determined twice over a 7- to 16-month period in 21 asthmatic children and a 13- to 60-month period in 14 normals. These children with two longitudinal visits were compared with a group of 107 normal children who had a single bone mineral density measurement.


RESULTS
Nineteen of 21 asthmatic children used regular inhaled corticosteroids during the interval visits. The majority of the asthmatic boys had bone mineral density measurements, at both visits, that were at a higher percentile than normal boys with two visits. Asthmatic girls had bone density measurements at percentiles not significantly different than normal girls with two visits.


CONCLUSIONS
The advancement of bone mineral density in asthmatic children provides support for the safety of inhaled anti-inflammatory medications on bone mineral density in children with significant asthma.
Hopp
R J
RJ
Department of Pediatrics, Creighton University, Omaha, NE 68178, USA.
Degan
J A
JA
Biven
R E
RE
Kinberg
K
K
Gallagher
G C
GC
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy*; D015519:Bone Density; D001846:Bone Development / Q000187:drug effects*; D002648:Child; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male
D000305:Adrenal Cortex Hormones