Evaluating Bone Metabolism In Asthmatic Cases Using Inhaled Steroids

Abstract

Background: Bronchial asthma is a chronic inflammatory disease in which eosinophils and different cells play a major role in pathogenesis, characterized by increased bronchial sensitivity of the airways. Topical steroids had been used to avoid long-term side effects of systemic steroids in asthma. The systemic effects of inhaled corticosteroids may be explained by the combined effects of many factors. Objective: This study was performed to investigate the effects of inhaled steroids on bone mineralization and also on bone density. Methods: Ninety-seven children divided into three groups, diagnosed with bronchial asthma and followed up in 2002 and 2003 at the GATA Haydarpasa Teaching Hospital were included in the study. Bone remodeling and destruction markers were used to examine the effects of inhaled steroids on bone metabolism. Results: Comparisons between groups and among all three groups revealed no statistical differences in bone specific alkaline phosphatase (bALP), hydroxyproline (HP), carboxy-terminal telopeptide of type1 collagen (ICTP), calcium-creatinine ratio (Ca/GF), calcium (Ca) and phosphor (P) levels. Analysis of the groups in the study revealed that bone mineral density (BMD) scores were significantly higher in pubertal stage cases compared with those in the prepubertal stage. Conclusion: No negative effect of inhaled steroid treatment on BMD was observed, and care must be taken over the use of the lowest dosage possible, especially in children, to keep respiratory functions and symptoms under control.