All issues > Volume 52(7); 2009

Original Article

Korean J Pediatr. 2009;52(7):811-817. Published online July 15, 2009.

Effects of inhaled corticosteroids on bone mineral density and bone metabolism in children with asthma

Ic Sun IS Choi¹, Jung Hye JH Byeon¹, Seung Min SM Lee², Kyong Suk KS La¹, Yeon Joung YJ Oh³, Young Y Yoo¹, Kee Hyoung KH Lee³, Ji Tae JT Choung¹

¹Department of Pediatrics, Environmental Research Center, Korea University Anam Hospital, Seoul, Korea
²Environmental Research Center, Korea University Anam Hospital, Seoul, Korea
³Department of Pediatrics, Korea University Anam Hospital, Seoul, Korea

Correspondence Young Y Yoo ,Email: yoolina@korea.ac.kr

Abstract

Purpose
: Inhaled corticosteroids (ICS) are used as first-line agents for the treatment of persistent asthma; however, their use is accompanied by apprehension of potential systemic adverse effects. This study aimed to assess the effects of ICS on bone mineral density (BMD) and bone metabolism in children with asthma.
Methods
: From February 2008 to September 2008, 26 asthmatic children treated with ICS (ICS group), 15 asthmatic children treated with leukotriene receptor antagonist (LTRA) (LTRA group), and 30 healthy children (Control group) were selected from the Korea University Anam Hospital. BMD and serum bone-specific alkaline phosphatase (BALP) levels were measured. The asthmatic children underwent spirometry and methacholine bronchial challenge test.
Results
: There were no significant differences in BMD in the lumbar spine (P=0.254) and proximal femur (P=0.297) among the 3 groups. The serum BALP levels were significantly higher in both the ICS (P=0.017) and LTRA (P=0.025) groups than in the Control group. None of the parameters pertaining to ICS use, such as the mean daily dose during the last 6 months, the total cumulative dose, duration of use, and age of commencement of use, showed significant correlations with BMD (P>0.05 for all parameters).
Conclusions
: We demonstrated that a low dose of ICS does not exert any significant adverse effect on bone metabolism in asthmatic children. These findings support the current recommendations with regard to the use of ICS for asthmatic children.

Keywords :Inhaled Corticosteroids, Bone Mineral Density, Bone Metabolism, Asthma, Children