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[Effect of budesonide on bone density and metabolism in asthmatic children]
M Paoli de Valeri1, E M Gómez, E Valeri
1Unidad de Endocrinología, Universidad de Los Andes-Hospital Universitario de Los Andes (ULA-HULA), Mérida, Venezuela.
Insights
Inhaled budesonide did not affect bone mineral density or metabolism in children with asthma. This study found no significant differences in bone formation or resorption markers between treated and untreated asthmatic children and a control group.
Area of Science:
- Pediatric Pulmonology
- Pediatric Endocrinology
- Bone Metabolism Research
Context:
- Asthma is a common chronic respiratory disease in children.
- Inhaled corticosteroids are a primary treatment for persistent asthma.
- Concerns exist regarding the potential long-term effects of corticosteroids on bone health in pediatric populations.
Purpose:
- To evaluate the impact of inhaled budesonide on bone mineral density, content, and metabolic markers in prepubertal children with asthma.
- To compare bone health parameters between asthmatic children treated with inhaled budesonide, untreated asthmatic children, and non-asthmatic children.
Summary:
- A cross-sectional study involved 38 children aged 6-11 years, divided into three groups: asthmatic children on inhaled budesonide, asthmatic children not on inhaled corticosteroids, and healthy controls.
- Bone formation and resorption markers, bone mineral density (DMO), and bone mineral content (CMO) were measured in all participants.
- No statistically significant differences were found in serum calcium, osteocalcin, ICTP levels, DMO, or CMO among the three groups.
Impact:
- This research suggests that short-term use of inhaled budesonide at recommended dosages (100-400 micrograms/day) does not adversely affect bone mineral density or metabolism in children with asthma.
- Findings contribute to the understanding of the safety profile of inhaled budesonide in pediatric asthma management.
- Further longitudinal studies may be warranted to confirm these findings over extended treatment periods.
Objective:
To assess the effect of inhaled budesonide on the mineral density, content and bone metabolism in children with asthma.
Material And Methods:
From September 1996 to July 1997, a cross-sectional study was conducted in 38 prepubertal children aged 6 to 11 years, selected from the pediatric chest outpatient clinic of the Instituto Autónomo Hospital Universitario de Los Andes, Mérida, Venezuela. Three study groups were assembled: 9 asthmatic children treated with inhaled budesonide (300 micrograms/day) for over 6 months (Group A); 14 asthmatic children not treated with inhaled corticosteroids (Group B); and 15 non-asthmatic children (Group C). All of them underwent testing of bone formation and resorption markers, and measurement of bone mineral density (DMO) and content (CMO). Statistical analysis consisted of central tendency and dispersion measures, analysis of variance, and Fisher and Scheffe tests for comparison of means.
Results:
In the groups studied (A, B, and C) calcium serum levels were 9.1 +/- 0.3; 9.6 +/- 0.4; 9.3 +/- 0.6 mg/ml, respectively; osteocalcin levels were 14.8 +/- 4.6; 13.0 +/- 2.5; 11.9 +/- 3.4 ng/dl; the type I collagen carboxyterminal telopeptide (ICTP) levels were 19.6 +/- 16.5; 14.2 +/- 15.4; 13.0 +/- 18.3 micrograms/l; the DMO levels were 0.67 +/- 0.06; 0.68 +/- 0.06; 0.69 +/- 0.06 g/cm2; and the CMO levels were 1,158.8 +/- 217.4; 1,106.4 +/- 256.1; 1,176.5 +/- 240.5 g, respectively. No statistically significant differences were observed between the groups.
Conclusions:
The administration of 100-400 micrograms/day of inhaled budesonide for a period of six months, did not change the bone mineral density and metabolism of asthmatic children.