[Effect of inhaled steroid on bone metabolism in the treatment of bronchial asthma].

In order to clarify the effects of longterm inhaled steroid therapy on bone metabolism, we examined 72 patients with bronchial asthma treated mainly with BDP (beclomethasone dipropionate). Multiple scanning X-ray photodensitometry was used to evaluate the degree of bone mineral loss. Osteocalcin, alkaline phosphatase (total and type III) was measured as a marker of bone synthesis and urinary pyridinoline, and deoxy-pyridinoline was measured as a marker of bone resorption. There was age related bone mineral loss. Urinary pyridinoline increased with aging. Treatment related bone mineral loss was not observed either in cases treated with BDP or in cases treated with continual oral steroids. Urinary pyridinoline and deoxy-pyridinoline decreased in patients treated with larger doses of for longer periods with BDP. Serum osteocalcin levels were lower in patients on continual oral corticosteroids. We conclude that inhaled steroid do not deteriorate bone metabolism in patients with bronchial asthma, when used appropriately.