[Inhaled corticosteroid therapy and bone metabolism in asthmatic children].
OBJECTIVE
To explore the association between inhaled corticosteroids (ICS) therapy and bone metabolism.


METHODS
The sample was composed of 151 children, aged between 1 and 17 years. There were 71 asthmatics treated with ICS for at least 6 months (group 1), 44 asthmatics treated occasionally with ICS during exacerbations (group 2), and 36 healthy children (group 3). Bone mineral density (BMD) and markers of bone formation and resorption were measured. These measures, as well as other related factors, were compared among groups. Regression models for osteopenia and BMD were used with the group as the independent variable adjusted by factors with differences between groups. A two-tailed level of p < 0.05 was used in all tests.


RESULTS
No differences in BMD were found between groups 1 and 2 but significant differences were found between groups 1 and 3 (p = 0.003). No differences were found in markers of bone formation and resorption among the groups. No association was found between BMD and the type, daily dose or accumulated dose of ICS. Group 1 showed an osteopenia odds ratio relative to group 3 of 2.94 (95 % CI: 1.49-5.78) and an average reduction of BMD of 0.50 (95 % CI: 0.32-0.68) was found from group 3 to 2 and from group 2 to 1. In group 1, markers of bone resorption significantly increased in asthmatics with osteopenia compared with those without osteopenia.


CONCLUSIONS
ICS treatment in asthmatic children seems to affect BMD. Markers of bone formation and resorption are unaffected. Osteopenia in these children could also be related to other factors that increase bone resorption.
Galván Fernández
C
C
Centros de Salud Laguna-S Benito y Finca, Spain. cgalvanf@comtf.es
Oliva Hernández
C
C
Suárez López de Vergara
R S
RS
Rodríguez Hernández
P J
PJ
Allende Riera
A
A
García-Nieto
V
V
Aguirre-Jaime
A
A
D000280:Administration, Inhalation; D000293:Adolescent; D001249:Asthma / Q000188:drug therapy* / Q000378:metabolism*; D015519:Bone Density / Q000187:drug effects*; D001842:Bone and Bones / Q000378:metabolism*; D019819:Budesonide / Q000008:administration & dosage* / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007223:Infant; D008297:Male
D005938:Glucocorticoids; D019819:Budesonide