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Uso de corticosteroides inhalados y densidad mineral ósea en pacientes con asma
C A Wong1, L J Walsh, C J Smith
1Division of Respiratory Medicine, City Hospital, Nottingham, UK. czwong@middlemore.co.nz
Lancet (London, England)
|May 3, 2000
Resumen
El uso a largo plazo de corticosteroides inhalados está relacionado con la reducción de la densidad mineral ósea en pacientes con asma. Las dosis acumuladas más altas se correlacionan con una menor densidad ósea, particularmente en la columna lumbar y el fémur.
Área de la Ciencia:
- Medicina Pulmonar La medicina pulmonar es el tratamiento de las enfermedades pulmonares.
- Endocrinología Endocrinología.
- Metabolismo óseo Metabolismo óseo.
Sus antecedentes:
- Los corticosteroides inhalados (ICS) son ampliamente utilizados para el manejo del asma.
- La absorción sistémica de ICS plantea preocupaciones sobre los posibles efectos adversos en la salud ósea.
- El impacto de la dosis acumulada de ICS en la densidad mineral ósea (DMO) requiere una aclaración debido al uso generalizado y a largo plazo.
Objetivo del estudio:
- Para investigar la relación dosis-respuesta entre la exposición acumulada a corticosteroides inhalados y la densidad mineral ósea.
- Evaluar la asociación entre la dosis de ICS y la DMO en sitios esqueléticos clave en adultos con asma.
Principales métodos:
- Un estudio en el que participaron 196 adultos (119 mujeres) de entre 20 y 40 años con asma.
- Evaluación de la dosis acumulada de ICS basada en la historia clínica y los registros médicos del paciente.
- Medición de la densidad mineral ósea en la columna lumbar y el fémur proximal utilizando análisis de regresión.
Principales resultados:
- Se observó una asociación negativa significativa entre la dosis acumulada de ICS y la DMO en la columna lumbar, el cuello femoral, el triángulo de Ward y el trocánter.
- Una duplicación de la dosis acumulada de ICS correspondió a una disminución de 0,16 SD en la DMO de la columna lumbar.
- Estas asociaciones se mantuvieron significativas después de ajustar por edad, sexo y otros posibles factores de confusión.
Conclusiones:
- El estudio proporciona evidencia de una relación negativa entre la dosis acumulada de corticosteroides inhalados y la densidad mineral ósea en pacientes con asma.
- Los hallazgos sugieren que el uso de ICS a largo plazo puede afectar negativamente la salud ósea, lo que requiere monitoreo.
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