Bone mineral density in prepubertal asthmatics receiving corticosteroid treatment

Objective: To examine whether bone mass is reduced in prepubertal, asthmatics receiving high doses of inhaled corticosteroids. Methodology: A cross-sectional comparison of lumbar spine-bone mineral density (LS-BMD) was undertaken in 76 subjects after stratifying them according to dosage and administration route of corticosteroid. Results: Weight was the only independent predictor of LS-BMD (r² = 0.38). Children receiving greater than 800 μg/day of inhaled corticosteroid plus intermittent oral corticosteroid had a significantly lower weight-adjusted LS-BMD than children treated with 400-800 μg/day of inhaled corticosteroid (mean difference: 0.06 g/cm², 95% confidence interval (CI): -0.02 to -0.10). A significant difference in weight-adjusted LS-BMD persisted when all children receiving greater than 800 μg/day of inhaled corticosteroid, irrespective of additional oral corticosteroid treatment, were compared with children receiving 400-800 μg/day of inhaled corticosteroid (mean difference: - 0.05 g/cm², 95%CI interval: -0.02 to -0.09). Bone mass was similar in children not receiving any inhaled corticosteroid and those treated with 400-800 μg/day of inhaled corticosteroid. Conclusions: A reduced bone mass in prepubertal asthmatic children receiving high doses of inhaled corticosteroids may predetermine a compromised peak bone mass and increase osteoporotic fracture risk in adulthood.