Inhaled corticosteroid use during childhood may reduce volumetric bone mineral density in the radius at school age

• Published in: Acta Paediatrica Vol. 103; no. 6; pp. 637 - 642
• Main Authors: Sidoroff, Virpi, Rikkonen, Toni, Hyvärinen, Mari, Kröger, Liisa, Kröger, Heikki, Korppi, Matti
• Format: Journal Article
• Language: English
• Published: Stockholm Blackwell Publishing Ltd 01.06.2014; Wiley Subscription Services, Inc
• Subjects: Asthma; Bone mineral density; Child; Inhaled corticosteroids; Quantitative computed tomography
• ISSN: 0803-5253; 1651-2227
• DOI: 10.1111/apa.12608

Aim Corticosteroids have harmful dose‐dependent effects on bone metabolism and growth. This study used a new method for volumetric measurements to evaluate the association between inhaled corticosteroids (ICS) for asthma and bone mineral density (BMD) in school‐aged children. Methods We evaluated children hospitalised for wheezing at the age of <24 months at 12.3 years (median). Volumetric BMD (vBMD) was measured using peripheral quantitative computed tomography (pQCT) from the distal tibia and radius in 82 children. Data on ICSs used were collected from hospital records and parent interviews. Cumulative doses and the duration of ICS therapy were calculated. Results Girls had higher total and cortical vBMD in the tibia than boys. Pubertal children had higher total and cortical vBMD in the radius than prepubertal children. Higher cumulative doses of ICSs were associated with lower total (r = −0.175, adjusted p = 0.016), cortical (r = −0.138, adjusted p = 0.016) and trabecular (r = −0.156, adjusted p = 0.039) vBMD in the radius, but not in the tibia. Age, weight or the cumulative dose of systemic corticosteroids had no significant associations with vBMD. Conclusion Although correlations between cumulative ICS doses and vBMD were weak, ICS use during childhood may reduce BMD in the radius at school age.