Inhaled corticosteroids may have a beneficial effect on bone metabolism in newly diagnosed asthmatic children - 02/08/11
, Malgorzata Olszowiec-Chlebna a, Joanna Jerzynska a, Tomasz Grzelewski a, Włodzimierz Stelmach b, Pawel Majak a
Corresponding author. Tel.: +48 42 689 59 72; fax: +48 42 689 59 73.Abstract |
Background |
The adverse effect of inhaled corticosteroids (ICS) treatment on bone metabolism in children with asthma is still controversial, and a possible beneficial effect of vitamin D added to ICS on bone turnover is uncertain.
Objective |
We conducted a randomized, double-blind, parallel-group, 6-month trial to assess the effects of a medium and high dose of ICS and a high-dose ICS with vitamin D on bone metabolism in children with newly diagnosed atopic asthma.
Methods |
96 children were equally randomized to 4 groups receiving the following doses of inhaled budesonide [μg/day]: 400 (ICS 400 group), 800 (ICS 800 group), 800 with oral vitamin D (ICS 800 with vit D group), and montelukast as a control (control group). Markers of bone production (osteocalcin, alkaline phosphatase) and bone degradation (amino-terminal cross-linked telopeptide of type I collagen – NTx, carboxy-terminal telopeptides of type I collage), and also concentration of 25-hydroxycholecalciferol (25OH D) and calcium–phosphorus balance (calcium, phosphorus, parathormon-PTH) in serum and/or urine were assessed twice: before and after 6 months of treatment.
Results |
We obtained a significant decrease in phosphorus and PTH serum levels in ICS 400 and ICS 800 with vit D groups compared to control group, and a significant decrease of NTx urine level in ICS 800 with vit D group.
Conclusions |
Medium doses of inhaled corticosteroids exert an advantageous effect on bone metabolism in newly diagnosed asthmatic children. Vitamin D together with a high dose of inhaled corticosteroids has a beneficial effect on both calcium–phosphorus balance and collagen turnover.
Le texte complet de cet article est disponible en PDF.Keywords : Asthma, Children, Bone metabolism, Inhaled corticosteroids, Vitamin D
Abbreviations : ALP, ATAQ, BMD, BMI, Ca, CS, FEV1, ICS, NTx, OC, 25OH D, P, PTH, SCTx
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Vol 24 - N° 4
P. 414-420 - août 2011 Retour au numéro
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