[Effect of budesonide on bone density and metabolism in asthmatic children]. / Efecto de budesonida sobre la densidad y el metabolismo óseo en niños asmáticos.

OBJECTIVE: To assess the effect of inhaled budesonide on the mineral density, content and bone metabolism in children with asthma. MATERIAL AND METHODS: From September 1996 to July 1997, a cross-sectional study was conducted in 38 prepubertal children aged 6 to 11 years, selected from the pediatric chest outpatient clinic of the Instituto Autónomo Hospital Universitario de Los Andes, Mérida, Venezuela. Three study groups were assembled: 9 asthmatic children treated with inhaled budesonide (300 micrograms/day) for over 6 months (Group A); 14 asthmatic children not treated with inhaled corticosteroids (Group B); and 15 non-asthmatic children (Group C). All of them underwent testing of bone formation and resorption markers, and measurement of bone mineral density (DMO) and content (CMO). Statistical analysis consisted of central tendency and dispersion measures, analysis of variance, and Fisher and Scheffe tests for comparison of means. RESULTS: In the groups studied (A, B, and C) calcium serum levels were 9.1 +/- 0.3; 9.6 +/- 0.4; 9.3 +/- 0.6 mg/ml, respectively; osteocalcin levels were 14.8 +/- 4.6; 13.0 +/- 2.5; 11.9 +/- 3.4 ng/dl; the type I collagen carboxyterminal telopeptide (ICTP) levels were 19.6 +/- 16.5; 14.2 +/- 15.4; 13.0 +/- 18.3 micrograms/l; the DMO levels were 0.67 +/- 0.06; 0.68 +/- 0.06; 0.69 +/- 0.06 g/cm2; and the CMO levels were 1,158.8 +/- 217.4; 1,106.4 +/- 256.1; 1,176.5 +/- 240.5 g, respectively. No statistically significant differences were observed between the groups. CONCLUSIONS: The administration of 100-400 micrograms/day of inhaled budesonide for a period of six months, did not change the bone mineral density and metabolism of asthmatic children.

[Adrenal function and lipid metabolism in asthmatic children treated with budesonide]. / Función adrenal y metabolismo lipídico en niños asmáticos tratados con budesonida.

OBJECTIVE: To assess the effect of low doses of inhaled budesonide on the adrenal function and lipid metabolism of asthmatic children. MATERIAL AND METHODS: The study included 10 asthmatic children (mean age, 8.8 years) treated with inhaled budesonide (200-300 micrograms/day) for a period longer than 3 months (group A); 15 asthmatic children (mean age, 7.8 years) without steroid treatment (group B) and 10 non-asthmatic children (group C). Basal cortisol levels, as well as postACTH, adrenal androgens, lipids and urinary cortisol were determined. RESULTS: No significant differences were detected between groups A and B in the studied variables. In asthmatic children, urinary cortisol was significantly higher than in non-asthmatic children. Triglycerides, total cholesterol, low density lipoprotein cholesterol and atherogenic index levels were higher in asthmatic children with and without budesonide treatment, compared with non-asthmatic children. CONCLUSIONS: Treatment of asthmatic children with low doses of inhaled budesonide did not modify the adrenal axis function nor lipid metabolism. Asthmatic patients showed an atherogenic lipid profile which could increase the risk of cardiovascular disease.