Overnight urine growth hormone, cortisol and adenosine 3′ 5′ cyclic monophosphate excretion in children with chronic asthma treated with inhaled beclomethasone dipropionate

Abstract

Overnight urine samples were obtained from 34 asthmatic children, 24 of whom were receiving inhaled beclomethasone dipropionate (BDP), and 30 controls. The urine volume of the children receiving inhaled steroids was significantly greater than that of the other asthmatic children and of the controls (P < 0.05). Urine growth hormone was within the normal range for all of the subjects and there was no demonstrable relationship between urine growth hormone and height or height standard deviation score. Urine steroid output was significantly reduced in the BDP receiving group when the results were expressed in U l-1 but there was no difference between the groups when the results were expressed per specimen. Urine adenosine 3' 5' cyclic monophosphate (cAMP) results were similar for all groups. We conclude that use of BDP increases overnight urine volume but, in our study, does not appear to influence the output of urine cortisol. Urine free cortisol measurements may not be a very sensitive tool for the detection of small changes in endogenous steroid production. The use of BDP does not adversely affect the output of urine growth hormone.

Effects of inhaled corticosteroids and inhaled cromolyn sodium on urinary growth hormone excretion in asthmatic children

“…Similar results appeared in recently published studies 15,25 in which U-GH secretion was not suppressed by current ICS therapy. Contrary to our results, the U-GH level in the CrS-treated group was found to be at the same level as in the ICS group.…”

“…[11][12][13][14] Previous studies demonstrated no relationship between excretion of GH, inhaled corticosteroids, and linear growth of asthmatic children. 15 The aim of this study was to evaluate the influence of the anti-inflammatory drugs, namely ICS and cromolyn sodium (CrS) on overnight U-GH levels in clinically wellcontrolled prepubertal asthmatic children.…”

Efficacy and Safety of Inhaled Corticosteroids

“…In contrast, 200 g/d and 400 g/d FP Diskhaler, and 400 g/d BUD Turbuhaler seemed to reduce urinary cortisol excretion (424). A significant effect on urinary cortisol excretion by 300-400 g/d BDP has been found in some studies (425)(426)(427)(428), whereas others did not find any effect at these same doses (429)(430)(431). Cortisol excretion was still within the normal range in all the studies that found a significant effect.…”

“…This gives further support to the view that such doses of inhaled corticosteroid are safe. Furthermore, daily doses of around 400 g (range 200-1,200 g) BUD and BDP do not adversely affect the output of urinary growth hormone (425,426,431).…”

Early use oe inhaled steroids in children with asthma

“…For example, studies have found sodium cromoglycate treatment to be associated with significant effects upon the excretion of growth hormone in the urine [59] and markers of bone metabolism [60]. Treatment with inhaled ^2-agonists has also been found to adversely affect the secretion of growth hormone [61,62]. Although statistically significant, these findings are probably not clinically relevant.…”