Bone mineral density in prepubertal asthmatics receiving corticosteroid treatment.
OBJECTIVE
To examine whether bone mass is reduced in prepubertal, asthmatics receiving high doses of inhaled corticosteroids.


METHODS
A cross-sectional comparison of lumbar spine-bone mineral density (LS-BMD) was undertaken in 76 subjects after stratifying them according to dosage and administration route of corticosteroid.


RESULTS
Weight was the only independent predictor of LS-BMD (r(2) = 0.38). Children receiving greater than 800 microg/day of inhaled corticosteroid plus intermittent oral corticosteroid had a significantly lower weight-adjusted LS-BMD than children treated with 400-800 microg/day of inhaled corticosteroid (mean difference: 0.06 g/cm(2), 95% confidence interval (CI): - 0.02 to - 0.10). A significant difference in weight-adjusted LS-BMD persisted when all children receiving greater than 800 microg/day of inhaled corticosteroid, irrespective of additional oral corticosteroid treatment, were compared with children receiving 400-800 microg/day of inhaled corticosteroid (mean difference: - 0.05 g/cm(2), 95%CI interval: -0.02 to - 0.09). Bone mass was similar in children not receiving any inhaled corticosteroid and those treated with 400-800 microg/day of inhaled corticosteroid.


CONCLUSIONS
A reduced bone mass in prepubertal asthmatic children receiving high doses of inhaled corticosteroids may predetermine a compromised peak bone mass and increase osteoporotic fracture risk in adulthood.
Harris
M
M
Department of Endocrinology, Sydney Children's Hospital, Randwick, New South Wales, Australia.
Hauser
S
S
Nguyen
T V
TV
Kelly
P J
PJ
Rodda
C
C
Morton
J
J
Freezer
N
N
Strauss
B J
BJ
Eisman
J A
JA
Walker
J L
JL
D015502:Absorptiometry, Photon; D000280:Administration, Inhalation; D000284:Administration, Oral; D000367:Age Factors; D000704:Analysis of Variance; D001249:Asthma / Q000188:drug therapy*; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D016014:Linear Models; D008159:Lumbar Vertebrae / Q000187:drug effects*; D008297:Male; D011239:Prednisolone / Q000494:pharmacology / Q000627:therapeutic use
D005938:Glucocorticoids; D011239:Prednisolone