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[Adrenal function and lipid metabolism in asthmatic children treated with budesonide]
M Paoli-de Valeri1, Y Zerpa-de Miliani, E G Valeri-Dávila
1Unidad de Endocrinología, Universidad de Los Andes (ULA), Instituto Autónomo Hospital Universitario de Los Andes (IAHULA), Mérida, Venezuela.
Insights
Low-dose inhaled budesonide did not affect adrenal function or lipid metabolism in children with asthma. However, asthmatic children exhibited an atherogenic lipid profile, increasing cardiovascular disease risk.
Area of Science:
- Pediatric Endocrinology
- Respiratory Medicine
- Cardiovascular Risk Assessment
Background:
- Asthma management often involves inhaled corticosteroids.
- Concerns exist regarding potential systemic effects of inhaled corticosteroids on adrenal function and metabolism.
- Understanding these effects is crucial for optimizing pediatric asthma care.
Purpose of the Study:
- To evaluate the impact of low-dose inhaled budesonide on adrenal axis function in asthmatic children.
- To assess the influence of inhaled budesonide on lipid metabolism in pediatric asthma patients.
- To compare these parameters between treated asthmatics, untreated asthmatics, and non-asthmatic controls.
Main Methods:
- A comparative study involving three groups: asthmatic children on inhaled budesonide (200-300 mcg/day), untreated asthmatic children, and non-asthmatic children.
- Assessment of basal cortisol, post-ACTH cortisol, adrenal androgens, serum lipids (triglycerides, total cholesterol, LDL-C), and urinary cortisol.
- Statistical analysis to compare variables across the groups.
Main Results:
- No significant differences in adrenal function or lipid profiles were observed between asthmatic children treated with low-dose inhaled budesonide and those untreated.
- Asthmatic children, regardless of budesonide treatment, showed significantly higher urinary cortisol levels compared to non-asthmatic children.
- Elevated levels of triglycerides, total cholesterol, LDL-cholesterol, and an increased atherogenic index were noted in asthmatic children compared to controls.
Conclusions:
- Low-dose inhaled budesonide does not appear to alter adrenal axis function or lipid metabolism in asthmatic children.
- Asthma itself is associated with an atherogenic lipid profile, potentially elevating cardiovascular disease risk.
- Further research may be warranted to explore the underlying mechanisms of dyslipidemia in pediatric asthma.
Objective:
To assess the effect of low doses of inhaled budesonide on the adrenal function and lipid metabolism of asthmatic children.
Material And Methods:
The study included 10 asthmatic children (mean age, 8.8 years) treated with inhaled budesonide (200-300 micrograms/day) for a period longer than 3 months (group A); 15 asthmatic children (mean age, 7.8 years) without steroid treatment (group B) and 10 non-asthmatic children (group C). Basal cortisol levels, as well as postACTH, adrenal androgens, lipids and urinary cortisol were determined.
Results:
No significant differences were detected between groups A and B in the studied variables. In asthmatic children, urinary cortisol was significantly higher than in non-asthmatic children. Triglycerides, total cholesterol, low density lipoprotein cholesterol and atherogenic index levels were higher in asthmatic children with and without budesonide treatment, compared with non-asthmatic children.
Conclusions:
Treatment of asthmatic children with low doses of inhaled budesonide did not modify the adrenal axis function nor lipid metabolism. Asthmatic patients showed an atherogenic lipid profile which could increase the risk of cardiovascular disease.