STUDY OF BONE MINERAL DENSITY IN ASTHMATIC CHILDREN RECEIVING CORTICOSTEROIDS | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 2, Volume 27, Issue 1, January 2024, Page 3737-3750 PDF (156.91 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2024.351082 | ||||
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| Abstract | ||||
| Background: Inhaled corticosteroid (ICS) is the most effective controller therapy for children with persistent asthma. It significantly reduces hospital admission in asthma exacerbation and may be used alone for mild-to-moderate asthma exacerbation or in combination with systemic corticosteroids for moderate-to-severe asthma exacerbation. Decreased bone mineral density and growth suppression is one of the side effects of Corticosteroids use due to Blunting of pulsatile growth hormone release, down-regulation of growth hormone receptor expression, inhibition of insulinlike growth factor-1 bioactivity. Aim: To measure the bone mineral density in asthmatic children receiving corticosteroid, to identify child at risk for diminished bone density before entering adulthood allowing for therapeutic interventions. Patients and Methods: A cross sectional comparative study was performed on 90 asthmatic children aged between 5 and 12 years old, during the period from March 2020 up to March 2021. The patients were diagnosed as having a moderate persistent to severe asthma, as defined by the presence of daily symptoms, frequency of exacerbations and the use of inhaled bronchodilator according to GINA strategy. They were classified into three groups. Group I included 30 asthmatic patients with moderate or severe persistent asthma on inhaled corticosteroids. Group II included 30 asthmatic patients with moderate or severe persistent asthma on systemic corticosteroids. Group III was the control group and included 30 asthmatic patients not receiving corticosteroids. Total doses of inhaled corticosteroids (ICS) and oral corticosteroids (OCSs) were recorded, serum 25-hydroxyvitamin D3 levels were measured and dual-energy x-ray absorptiometry scan of the lumbar spine was performed. Results: There was a significant difference in bone density between asthmatic children receiving steroids and control subjects. Reduction in bone mineral density was dependent on the duration of oral corticosteroid therapy. While inhaled steroid was associated with a minimal decrease in bone mineral density. Serum vitamin D was decreased in 83.3% of studied patients, regardless of the use of Corticosteroids or not. 16.7% of studied patients had normal serum vitamin D level. Conclusion: Oral and inhaled steroid therapy in children with moderate to severe asthma was associated with decrease in bone mineral density. Keywords: Asthma, Bone mineral density, Corticosteroids, Vit D, DXA Scan. | ||||
| Keywords | ||||
| Asthma; Bone mineral density; Corticosteroids; Vit D; DXA Scan | ||||
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