Bone Mineral Density in Children Treated With Daily or Periodical Inhaled Budesonide: The Helsinki Early Intervention Childhood Asthma Study
Bone Mineral Density in Children Treated With Daily or Periodical Inhaled Budesonide: The Helsinki Early Intervention Childhood Asthma Study
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DOI：
10.1203/pdr.0b013e3181e69e36
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发表时间：
2010-08
影响因子：
3.6
通讯作者：
M. Turpeinen;A. Pelkonen;K. Nikander;R. Sorva;O. Selroos;K. Juntunen‐Backman;T. Haahtela
中科院分区：
文献类型：
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作者：
M. Turpeinen;A. Pelkonen;K. Nikander;R. Sorva;O. Selroos;K. Juntunen‐Backman;T. Haahtela
在一项随机双盲研究中，136名5 - 10岁的新发现持续性哮喘的儿童接受布地奈德（budd） 400 μg每日2次，持续1个月，随后接受200 μg每日2次，持续5个月。此后，50名儿童接受100 μg每日2次的budd治疗，44名儿童根据需要使用budd，持续1个月；另外42名儿童接受了异糖酸二钠（DSCG）治疗。所有组均给予400 μg BUD治疗哮喘加重2周，每日2次。在这一次要分析中，测量了治疗前后18个月腰椎的骨矿物质密度（BMD）。与DSCG相比，常规BUD治疗导致BMD（0.023对0.034 g/cm2, p = 0.023）和身高（7.75对8.80 cm, p = 0.001）的增加明显较小。定期治疗对骨密度无影响。当BMD数据根据身高变化进行调整时，没有观察到组间差异。青春期前儿童每日服用BUD可减缓骨密度和站立高度的增加。在最初的常规BUD治疗后定期接受BUD治疗的儿童中没有观察到这一点。身高与骨密度之间的相关性表明，跟踪儿童的身高可能有助于估计吸入皮质类固醇对骨骼的影响。
In a double-blind, randomized study, 136 children, 5–10-y-old, with newly detected persistent asthma received budesonide (BUD) 400 μg twice daily for 1 mo and thereafter 200 μg twice daily for 5 mo. Thereafter, 50 children were treated with BUD 100 μg twice daily, whereas 44 children used BUD as needed for 1 y; an additional 42 children received disodium cromoglycate (DSCG). Asthma exacerbations were treated with BUD for 2 wk in a dose of 400 μg twice daily in all groups. In this secondary analysis, bone mineral density (BMD) of the lumbar vertebrae was measured before and after the 18-mo treatment. Compared with DSCG, regular BUD treatment resulted in a significantly smaller increase in BMD (0.023 versus 0.034 g/cm2; p = 0.023) and height (7.75 versus 8.80 cm; p = 0.001). Periodic treatment did not affect BMD. No intergroup differences were observed when BMD data were adjusted for changes in height. Daily BUD treatment in prepubertal children may slow down the increment in BMD and standing height. This was not observed in children receiving BUD periodically after the initial regular BUD treatment. The correlation between height and BMD suggests that following children's height might afford an estimation of inhaled corticosteroid effects on bone.