LONGITUDINAL ASSESSMENT OF BONE-MINERAL DENSITY IN CHILDREN WITH CHRONIC ASTHMA

Background: With the emphasis on asthma as a chronic inflammatory proc ess, the management of moderate to severe asthma, even in the pediatri c population, has shifted to the regular use of inhaled anti-inflammat ory agents, including inhaled corticosteroids. Accompanying the use of these agents has been the precaution that long-term use may have subt le or potential side effects, including growth suppression or decrease d bone mineral deposition. Objective: We sought to study the effects o f inhaled anti-inflammatory agents on bone mineral density accumulatio n in growing asthmatic children. Included in this report is the longit udinal acquisition of bone mineral density in children with moderate t o severe asthma. Methods: Bone mineral density in normal and asthmatic children was measured longitudinally by dual-energy absorptiometry. B one densitometry was determined twice over a 7- to 16-month period in 21 asthmatic children and a 13- to 60-month period in 14 normals. Thes e children with two longitudinal visits were compared with a group of 107 normal children who had a single bone mineral density measurement. Results: Nineteen of 21 asthmatic children used regular inhaled corti costeroids during the interval visits. The majority of the asthmatic b oys had bone mineral density measurements, at both visits, that were a t a higher percentile than normal boys with two visits. Asthmatic girl s had bone density measurements at percentiles not significantly diffe rent than normal girls with two visits. Conclusions: The advancement o f bone mineral density in asthmatic children provides support for the safety of inhaled anti-inflammatory medications on bone mineral densit y in children with significant asthma.