Changes in body water distribution during treatment with inhaled steroid in pre-school children.
OBJECTIVE
The study aimed to examine the changes in water distribution in the soft tissue during systemic steroid activity.


METHODS
A three-way cross-over, randomized, placebo-controlled, double-blind trial was used, including 4 weeks of fluticasone propionate pMDI 200 microg b.i.d. delivered via Babyhaler, budesonide pressurized metered dose inhaler (pMDI) 200 microg b.i.d. delivered via Nebuchamber and placebo. Spacers were primed before use. In total, 40 children aged 1-3 years, with mild intermittent asthma were included. Twenty-five of the children completed all three treatments. At the end of each treatment period body impedance and skin ultrasonography were measured.


METHODS
We measured changes in water content of the soft tissues by two methods. Skin ultrasonography was used to detect small changes in dermal water content, and bioelectrical impedance was used to assess body water content and distribution.


RESULTS
We found an increase in skin density of the shin from fluticasone as measured by ultrasonography (p = 0.01). There was a tendency for a consistent elevation of impedance parameters from active treatments compared to placebo although overall this effect was not statistically significant (0.1 < p < 0.2). However, sub-analyses indicated a significant effect on whole-body and leg impedance from budesonide treatment (p < 0.05).


CONCLUSIONS
Decreased growth during inhaled steroid treatment seems to partly reflect generalized changes in body water.
Heitmann
B L
BL
Research Unit for Dietary Studies and the Danish Epidemiology Science Centre at the Institute of Preventative Medicine, Copenhagen University Hospital, Copenhagen Denmark. blh@ipm.hosp.dk
Anhøj
J
J
Bisgaard
A M
AM
Ward
L
L
Bisgaard
H
H
D000280:Administration, Inhalation; D000730:Androstadienes / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000188:drug therapy; D001834:Body Water / Q000378:metabolism*; D001993:Bronchodilator Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019819:Budesonide / Q000009:adverse effects* / Q000627:therapeutic use; D002675:Child, Preschool; D018592:Cross-Over Studies; D004311:Double-Blind Method; D017097:Electric Impedance; D005260:Female; D000068298:Fluticasone; D006801:Humans; D008297:Male; D012867:Skin / Q000000981:diagnostic imaging / Q000378:metabolism; D014463:Ultrasonography
D000730:Androstadienes; D001993:Bronchodilator Agents; D019819:Budesonide; D000068298:Fluticasone