Puberty and prognosis of asthma and bronchial hyper-reactivity

It is a commonly held view that pediatric asthma frequently abates during p uberty. However, little data are available that associate the stage of pube rty with the prognosis of asthma and bronchial hyper-reactivity (BHR). In t his study, 155 children with active asthma at 10 years of age (60 girls [38 .7%], 95 boys [61.3%]) were followed-up until they reached 14 years of age. The stage of puberty was assessed by parental questionnaire: in addition, serum 3-alpha -androstanediolglucuronide, as an endocrinological marker for peripheral androgen status, was measured in 107 subjects. Persistence of a sthma was determined via questionnaire, lung function testing, and bronchia l provocation (hyperventilation of cold, dry air). At 14 years of age, 73.3 % of girls were reported to have had menarche and 40.8% of boys a voice cha nge, and only 35.5% of the subjects had experienced acute asthma symptoms d uring the last 12 months, with an almost unchanged gender ratio (19 girls [ 34.5%], 36 boys [65.5%]) vs. that recorded at 10 years of age. The level of androstanediolglucuronide was higher in the children who reported puberty (mean +/- SD): 3.03+/-2.13 nmol/l vs. 1.89t1.26 nmol/l, p = 0.003. No stati stically significant relationship was found between the reported signs of l ate puberty and loss of asthma or BHR. Likewise, no significant association was found between asthma persistence and the level of androstanediolglucur onide (2.39 +/- 1.75 nmol/l vs. 2.44 +/- 1.82 nmol/l. p = 0.84), or BHR and the level of androstanediolglucuronide (3.02 +/- 1.97 nmol/l vs. 2.28 +/- 1.67 nmol/l, p = 0.13), at 14 years of age, in girls or boys. At 14 years o f age, no change in the gender ratio of children with active asthma had occ ured. These results may indicate that the change in gender predominance of asthma through the second decade of life is not caused by increased loss of established asthma in boys between 10 and 14 years of age.