Birkebaek N H, Esberg G, Andersen K, Wolthers O, Hassager C
Department of Paediatrics, Arhus University Hospital, Denmark.
Arch Dis Child. 1995 Dec;73(6):524-7. doi: 10.1136/adc.73.6.524.
To assess bone and collagen turnover in asthmatic children treated with dry powder budesonide from the Turbuhaler and dry powder beclomethasone dipropionate from the Diskhaler in a dose of 800 micrograms/day.
Thirteen prepubertal children with asthma.
Open crossover study with two treatment periods and treatment free run-in and wash-out periods. All periods were of two weeks' duration. At day 14 in each period blood samples were taken for assessment of serum osteocalcin, the carboxyterminal propeptide of type I collagen (PICP), and the aminoterminal propeptide of type III collagen (PIIINP). At the same time urine was collected for assessment of creatinine corrected pyridinoline (uPYR/cr) and deoxypyridinoline (udPYR/cr) crosslinks.
Osteocalcin concentrations were not influenced by any of the treatments. During budesonide treatment mean (SEM) PICP was reduced by 18% (8%) (p = 0.03), PIIINP by 24% (3%) (p = 0.0002), uPYR/cr by 16% (6%) (p = 0.03), and udPYR/cr by 21% (13%) (p = 0.12). During treatment with beclomethasone dipropionate mean (SEM) PICP was reduced by 20% (6%) (p = 0.01), PIIINP by 36% (3%) (p = 0.0002), uPYR/cr by 18% (4%) (p = 0.004), and udPYR by 13% (5%) (p = 0.02). The suppressive effect of beclomethasone dipropionate on PIIINP was more marked than that of budesonide (p = 0.001).
Treatment with dry powder budesonide and beclomethasone dipropionate 800 micrograms/day is associated with suppression of bone and collagen turnover. The suppression seems to be more marked during treatment with beclomethasone dipropionate. Long term effects and effects of lower doses of budesonide and beclomethasone dipropionate on bone and collagen markers needs further study.
评估使用都保干粉吸入剂型的布地奈德和准纳器干粉吸入剂型的丙酸倍氯米松，以每日800微克的剂量治疗的哮喘儿童的骨和胶原蛋白转换情况。
13名青春期前哮喘儿童。
开放性交叉研究，包括两个治疗期以及治疗前的导入期和洗脱期。所有阶段均持续两周。在每个阶段的第14天采集血样，以评估血清骨钙素、I型胶原蛋白羧基末端前肽（PICP）和III型胶原蛋白氨基末端前肽（PIIINP）。同时收集尿液，以评估肌酐校正的吡啶啉（uPYR/cr）和脱氧吡啶啉（udPYR/cr）交联物。
骨钙素浓度不受任何一种治疗的影响。在布地奈德治疗期间，平均（标准误）PICP降低了18%（8%）（p = 0.03），PIIINP降低了24%（3%）（p = 0.0002），uPYR/cr降低了16%（6%）（p = 0.03），udPYR/cr降低了21%（13%）（p = 0.12）。在丙酸倍氯米松治疗期间，平均（标准误）PICP降低了20%（6%）（p = 0.01），PIIINP降低了36%（3%）（p = 0.0002），uPYR/cr降低了18%（4%）（p = 0.004），udPYR降低了13%（5%）（p = 0.02）。丙酸倍氯米松对PIIINP的抑制作用比布地奈德更显著（p = 0.001）。
使用每日800微克的布地奈德干粉和丙酸倍氯米松干粉治疗与骨和胶原蛋白转换的抑制有关。丙酸倍氯米松治疗期间的抑制作用似乎更显著。布地奈德和丙酸倍氯米松较低剂量对骨和胶原蛋白标志物的长期影响需要进一步研究。
