The effects of inhaled glucocorticoids on bone mass and biochemical markers of bone homeostasis: a 1-year study of beclomethasone versus budesonide.
Bone mass and biochemical bone markers were prospectively studied in 33 patients with chronic obstructive pulmonary disease treated for 1 year with inhaled beclomethasone 200 micrograms/q.i.d. (group A, 8 men and 4 women), inhaled budesonide 200 micrograms/q.i.d. (group B, 6 men and 5 women), or not requiring steroids (group C, 6 men and 4 women). Both inhaled corticosteroids decreased serum concentrations of the osteoblastic markers, osteocalcin and carboxy-terminal propeptide of type I collagen (PICP). The osteoclastic marker cross-linked carboxy-terminal telopeptide of type I collagen (ICTP) increased significantly more in patients on beclomethasone than in those on budesonide. The decrease in bone mineral density was more pronounced in patients treated with beclomethasone (1.1% in the spine 1.7% in the hip P < 0.05) compared to those treated with budesonide (0.6% in both spine and hip) or in the control group. Inhaled corticosteroids affect biochemical bone markers and bone mineral density, but there is a different effect for the two corticosteroids evaluated in the present study.
Struijs
A
A
Department of Internal Medicine, St. Clara Hospital, Rotterdam, Netherlands.
Mulder
H
H
D000280:Administration, Inhalation; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001507:Beclomethasone / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D019819:Budesonide; D002118:Calcium / Q000097:blood; D003094:Collagen / Q000097:blood; D024042:Collagen Type I; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006706:Homeostasis; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015675:Osteocalcin / Q000097:blood; D010024:Osteoporosis / Q000139:chemically induced / Q000175:diagnosis; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011282:Pregnenediones / Q000008:administration & dosage* / Q000009:adverse effects; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies
D015415:Biomarkers; D024042:Collagen Type I; D005938:Glucocorticoids; D010446:Peptide Fragments; D010455:Peptides; D011282:Pregnenediones; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C042813:procollagen type I carboxy terminal peptide; D015675:Osteocalcin; D019819:Budesonide; D003094:Collagen; D000469:Alkaline Phosphatase; D001507:Beclomethasone; D002118:Calcium