Does treatment of asthmatic children with inhaled corticosteroids affect their adult height?

In this retrospective study, adult height was assessed in young adult asthm atics who were treated with inhaled corticosteroids (ICs) during childhood (n = 42; 26 boys) and compared to those obtained in asthmatic patients who were never treated with ICs during childhood (n = 43; 23 boys). Standing he ight of all subjects and their parents was measured. Height data were analy zed using actual length and target height in centimeters, standard deviatio n scores (SDS), and difference between adult height of the patients and the ir target height (adult height minus target height). Mean adult height was the same in subjects who took ICs during childhood as compared to those who had never received ICs (boys: 179.3 cm +/- 6.8 vs. 1 80.4 cm +/- 5.6; girls: 165.8 cm +/- 7.5 vs. 167.7 cm +/- 7.2). SDS of adul t height was also not different between the two groups: in subjects who did not take ICs it was 0.89 +/- 1.00, while in those who took ICs it was 0.66 +/- 1.10 (P = 0.31). SDS of target height was also not different between t he two groups: in subjects not taking ICs it was 0.95 +/- 0.86, while in th ose who took ICs it was 0.28 +/- 0.76 (P = 0.30). However, subjects who too k ICs during childhood showed a statistically significant lower value of ad ult height minus target height than those who never took ICs (whole group: -0.003 +/- 5.9 vs. 2.54 +/- 4.8, P = 0.03; boys: 0.004 +/- 5.8 vs. 3.09 +/- 4.5, P = 0.04; girls: -0.075 +/- 6.3 vs. 1.91 +/- 5.2, P= 0.31). Patients on ICs during childhood who had ever been hospitalized for asthma showed a lower value for adult height minus target height than those who took ICs bu t were never hospitalized (-3.08 +/- 7.8 vs. 1.06 +/- 4.8, P = 0.046). A lo gistic regression analysis predicting growth impairment showed that the bes t-fitting model was one that used only ICs as a dependent variable (crude o dds ratio, 3.3; 95% CI, 1.3-8.4). Patients who were treated with ICs in com bination with intranasal corticosteroids (treatment for rhinitis) tended to have a lower value of adult height minus target height than the other chil dren, but the difference was not statistically significant (P = 0.07). We conclude that although adult height was the same in young adults who wer e treated with ICs during childhood compared to those who were not treated with ICs during childhood, there was a statistically significant difference between the two groups for adult height minus target height, suggesting mi ld growth retardation in patients who took ICs during childhood. These find ings may be explained by the use of ICs, but it seems more likely that a di fference in asthma severity between both groups was responsible for it. Ped iatr Pulmonol, 1999; 27:369-375, (C) 1999 Wiley-Liss, Inc.