Osteocalcin, growth, and inhaled corticosteroids: a prospective study

Area of Science:

• Pediatric Endocrinology
• Respiratory Medicine
• Bone Metabolism

Background:

• Inhaled corticosteroids (ICS) are standard treatment for childhood asthma.
• ICS can cause growth suppression, necessitating monitoring.
• Biochemical markers of bone metabolism are potential surrogate markers for growth changes.

Purpose of the Study:

• To investigate the relationship between bone metabolism markers and statural growth.
• To assess the utility of serum osteocalcin and urinary deoxypyridinoline as surrogate markers for ICS-induced growth suppression.

Main Methods:

• A randomized, double-blind, placebo-controlled trial involving 7-9 year old children with recurrent wheeze.
• Intervention: Inhaled beclomethasone dipropionate (200 mcg twice daily) or placebo for six months.
• Outcome Measures: Serum osteocalcin, urinary deoxypyridinoline, and statural growth.

Main Results:

• No significant difference in serum osteocalcin between groups at any time point.
• Urinary deoxypyridinoline was higher in the placebo group after three months.
• Significant growth reduction was observed in the beclomethasone dipropionate group.
• Growth correlated significantly with serum osteocalcin at 3 and 6 months in both groups.

Conclusions:

• Serum osteocalcin demonstrates a strong correlation with overall growth.
• However, serum osteocalcin is not a suitable surrogate marker for detecting ICS-induced growth suppression.
• The findings highlight the need for more specific biomarkers to monitor ICS side effects.