title: Effects of high-dose inhaled corticosteroids on bone metabolism in prepubertal children with asthma.
abstract: We studied the effect of inhaled corticosteroids on the increase in bone mineral content in prepubertal children with asthma. Forty-eight asthmatic, prepubertal children receiving either inhaled beclomethasone dipropionate or budesonide were evaluated. Nine children of similar age not receiving inhaled steroids served as controls. The average age of corticosteroid-treated children was 7.8 +/- 2.4 years, and of control children, 8.4 +/- 2.1 years (NS). The average dose of inhaled corticosteroids in the treated children was 0.67 +/- 0.48 mg/m(2)/day, and they were followed over a 9-20-month period. Total bone mineral content (TBMC) was measured at baseline and after 9-20 months. A derived value for 12 months' TBMC was calculated, assuming that changes in TBMC were linear with the passage of time. The change in TBMC over a 12-month period was 264 +/- 68 mg for the corticosteroid-treated children and 330 +/- 84 mg for control children (P < 0.025). In a multiple regression analysis in which adjustments were made for the effects of age, height, and weight, the change in TBMC in corticosteroid-treated children was inversely related to the inhaled steroid dose/m(2)/day (P = 0.016). The increase in the lumbar vertebral bone mineral density in control children was also significantly greater than in the corticosteroid-treated children (P < 0.025). We conclude that inhaled steroids, at an average dose of 0.67 mg/m(2)/day, when used in the treatment of asthma reduce the acquisition of bone mineral in prepubertal children.
authors.affiliation: Department of Paediatrics, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: H D
authors.initials: HD
authors.lastname: Allen
authors.forename: I G
authors.initials: IG
authors.lastname: Thong
authors.forename: P
authors.initials: P
authors.lastname: Clifton-Bligh
authors.forename: S
authors.initials: S
authors.lastname: Holmes
authors.forename: L
authors.initials: L
authors.lastname: Nery
authors.forename: K B
authors.initials: KB
authors.lastname: Wilson
mesh_terms: D015502:Absorptiometry, Photon; D000280:Administration, Inhalation; D000287:Administration, Topical; D000293:Adolescent; D000367:Age Factors; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism; D001507:Beclomethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D001827:Body Height; D015992:Body Mass Index; D001835:Body Weight; D015519:Bone Density / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects* / Q000378:metabolism; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019819:Budesonide / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000378:metabolism; D008297:Male; D011627:Puberty
chemical_list: D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D005938:Glucocorticoids; D019819:Budesonide; D001507:Beclomethasone