title: Influence of inhaled corticosteroids on pubertal growth and final height in asthmatic children.
abstract: Controversial data exist on the possibility that inhaled corticosteroids (ICs) affect growth in children with mild-to-moderate asthma. We assessed whether ICs affect growth and final height (FH) in asthmatic children compared to controls.
  
  
  
  A retrospective study was conducted on 113 asthmatic children compared with 66 control children. Asthmatic children presented with mild-to-moderate asthma and had exclusive ICs. Anthropometric data of four specific time-points were collected for both groups (pre-puberty, onset and late puberty, and FH) and converted to standard deviation scores (SDS). Growth trajectories were assessed as follows: (i) in puberty, using peak height velocity (PHV) and pubertal height gain SDS (PHG-SDS); (ii) until FH achievement, using FH-SDS and FH gain SDS (FHG-SDS). Repeated measurement analysis was performed across longitudinal study visits. A general linear model (GLM) was performed in asthmatic group evaluating the effect of corticosteroid type, treatment duration, and cumulative dose on FH corrected for multiple variables.
  
  
  
  At pre-puberty, height and weight SDS were similar between the groups (p > 0.05). Height SDS progressively declined over the study period in asthmatic patients from pre-puberty to FH (p-trend < 0.05), whereas it did not change over time in controls (p-trend > 0.05), in both boys and girls. Asthmatic children had exclusive ICs [budesonide (n = 36) vs. fluticasone (n = 43) vs. mometasone (n = 34)] for a mean period of 6.25 ± 1.20 years and a mean cumulative dose of 560.07 ± 76.02 mg. They showed decreased PHG-SDS and lower PHV compared to controls (all p < 0.05). FH-SDS and FHG-SDS were significantly reduced in asthmatic group compared to controls. FH in asthmatic patients was 2.5 ± 2.89 cm lower in boys and 2.0 ± 2.03 cm lower in girls than controls. The GLM showed that FH achievement was dependent on the type of ICs, duration of the treatment, and cumulative dose (p < 0.05).
  
  
  
  ICs affect pubertal growth determining reduced final height in asthmatic children compared to controls, in a dose- and duration-dependent manner.
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: De Leonibus
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Marina
authors.initials: M
authors.lastname: Attanasi
authors.affiliation: Riga Stradins University Faculty of Continuing Education, Children's Clinical University Hospital, Riga, Latvia.
authors.forename: Zane
authors.initials: Z
authors.lastname: Roze
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Benedetta
authors.initials: B
authors.lastname: Martin
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.|Center of Excellence on Aging, "G. D'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Maria Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Di Pillo
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.|Center of Excellence on Aging, "G. D'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.affiliation: Department of Pediatrics, University of Chieti, Chieti, Italy.|Center of Excellence on Aging, "G. D'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Angelika
authors.initials: A
authors.lastname: Mohn
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D018927:Anti-Asthmatic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006128:Growth / Q000187:drug effects; D006801:Humans; D007558:Italy; D008297:Male; D012189:Retrospective Studies; D012741:Sexual Maturation / Q000187:drug effects
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents
keywords: asthma; children; growth; inhaled corticosteroid therapy; puberty