Objective: To examine whether bone mass is reduced in prepubertal, asthmati
cs receiving high doses of inhaled corticosteroids.
Methodology: A cross-sectional comparison of lumbar spine-bone mineral dens
ity (LS-BMD) was undertaken in 76 subjects after stratifying them according
to dosage and administration route of corticosteroid.
Results: Weight was the only independent predictor of LS-BMD (r(2) = 0.38).
Children receiving greater than 800 mug/day of inhaled corticosteroid plus
intermittent oral corticosteroid had a significantly lower weight-adjusted
LS-BMD than children treated with 400-800 mug/day of inhaled corticosteroi
d (mean difference: 0.06 g/cm(2), 95% confidence interval (CI): -0.02 to -0
.10). A significant difference in weight-adjusted LS BMD persisted when all
children receiving greater than 800 mug/day of inhaled corticosteroid, irr
espective of additional oral corticosteroid treatment, were compared with c
hildren receiving 400-800 mug/day of inhaled corticosteroid (mean differenc
e: -0.05 g/cm(2), 95%CI interval: -0.02 to -0.09). Bone mass was similar in
children not receiving any inhaled corticosteroid and those treated with 4
00-800 mug/day of inhaled corticosteroid.
Conclusions: A reduced bone mass in prepubertal asthmatic children receivin
g high doses of inhaled corticosteroids may predetermine a compromised peak
bone mass and increase osteoporotic fracture risk in adulthood.