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Asthma, inhaled corticosteroid use, and bone mass in prepubertal children

G Jones1, A L Ponsonby, B J Smith

  • 1Menzies Centre for Population Health Research, University of Tasmania, Hobart, Australia. g.jones@utas.edu.au

The Journal of Asthma : Official Journal of the Association for the Care of Asthma
|November 4, 2000
PubMed

Insights

Inhaled corticosteroid (ICS) use in children with asthma may impact bone health, particularly at higher doses. Current asthma guidelines for ICS usage are supported, but further research is needed.

Area of Science:

  • Pediatric Pulmonology
  • Pediatric Endocrinology
  • Pediatric Bone Health

Background:

  • Asthma is a common chronic respiratory disease in children.
  • Bone health is crucial during childhood for long-term skeletal integrity.
  • The impact of asthma and its treatments on pediatric bone mineralization requires further elucidation.

Purpose of the Study:

  • To investigate the association between asthma, asthma severity, and medication use with bone mineralization in prepubertal children.
  • To assess the role of inhaled corticosteroids (ICS) dosage and duration on bone density in pediatric asthma patients.

Main Methods:

  • Cross-sectional study involving 330 prepubertal children.
  • Assessment of asthma, severity, medication usage, and physical activity via questionnaires and objective measures.
  • Bone densitometry and body composition analyzed using dual-energy x-ray absorptiometry (DXA).

Main Results:

  • Asthma diagnosis itself was not linked to bone mass deficits.
  • Current use of inhaled corticosteroids (ICS) within the past year, not past use, correlated with reduced bone mass.
  • Higher ICS doses (≥400 μg/day) showed a more pronounced association with bone deficits, especially after adjusting for confounders.

Conclusions:

  • Current recommendations regarding ICS usage in children appear supported by these findings.
  • Higher doses and recent use of ICS may negatively affect bone mineralization in prepubertal children.
  • Longitudinal studies are necessary to confirm these associations and understand long-term effects.

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