Alyasin Soheila, Sadeghi Fateme S, Saki Forough, Dabaghmanesh Mohamadhosein
Allergy Research Center Shiraz University of Medical Sciences Shiraz Iran.
Student Research Committee Shiraz University of Medical Sciences Shiraz Iran.
Health Sci Rep. 2024 May 30;7(6):e2086. doi: 10.1002/hsr2.2086. eCollection 2024 Jun.
Asthma is a chronic inflammatory pulmonary disease which affects 10%-20% of children and adolescents. Inhaled corticosteroids (ICS) is one of its most effective therapies. The effect of systemic corticosteroids on decreasing bone mineral density (BMD) was investigated and proved in children; however, the influence of ICSs on bone density has still remained unclear. This study evaluates the bone mineral density of children and adolescents with asthma in southern Iran and the associated factors, for example, amount of used inhaled steroid.
This case-control study enrolled 41 children and adolescents (aged 8-18 years) with asthma and their age and gender-matched controls in 2019-2020. Serum Calcium, phosphate, vitamin D, and bone mineral density were measured. Their physical activity, sun exposure, and fracture history were evaluated subjectively.
Lumbar BMD and BMD Z-score in patients showed no significant difference with controls ( = 0.23, = 0.73). Also, it showed that there was no significant difference in biochemical studies, growth, and bone densitometry parameters between patients who used ICSs for less than 3 months/year corticosteroid therapy compared to those with equal or more than 3 months/year usage. Prevalence of vitamin D deficiency was 28% and 8% in the controls and patients, respectively ( = 0.005).
The present study showed that 9.46% of children and adolescents with asthma had low bone mass for chronological age, and it is not significantly higher than normal population. Dosage of inhaled steroid did not associate with osteoporosis in these patients. Prevalence of vitamin D deficiency in patients was lower than normal population, probably due to receiving vitamin D in their routine follow-ups.
哮喘是一种慢性炎症性肺部疾病,影响10%-20%的儿童和青少年。吸入性糖皮质激素(ICS)是其最有效的治疗方法之一。系统性糖皮质激素对儿童骨矿物质密度(BMD)降低的影响已得到研究和证实;然而,ICS对骨密度的影响仍不清楚。本研究评估了伊朗南部哮喘儿童和青少年的骨矿物质密度及其相关因素,例如吸入性类固醇的使用量。
本病例对照研究在2019年至2020年纳入了41名8至18岁的哮喘儿童和青少年及其年龄和性别匹配的对照。测量了血清钙、磷、维生素D和骨矿物质密度。主观评估了他们的身体活动、阳光暴露和骨折史。
患者的腰椎BMD和BMD Z评分与对照组无显著差异(P = 0.23,P = 0.73)。此外,与每年使用ICS少于3个月的患者相比,每年使用ICS等于或超过3个月的患者在生化研究、生长和骨密度测量参数方面也没有显著差异。对照组和患者中维生素D缺乏的患病率分别为28%和8%(P = 0.005)。
本研究表明,9.46%的哮喘儿童和青少年按年龄计算骨量较低,且并不显著高于正常人群。这些患者中吸入性类固醇的剂量与骨质疏松症无关。患者中维生素D缺乏的患病率低于正常人群,可能是由于在常规随访中接受了维生素D。