Long-term inhaled corticosteroid treatment and severe asthma in children - the impact on body height and weight

摘要

BackgroundChronic conditions such as asthma are usually stigmatizedas one of the reasons for short stature. A widespreadbelief also is that prolonged long-term treatmentwith corticosteroids will lead to elevated body weightand also could lead to short stature.Therefore we evaluated the height and weight statusin the children admitted in the hospital for asthmaattack regarding the asthma severity, the natural historyof asthma and inhaled corticosteroid (ICS) treatmentperiod.Material and methodFor a period of 6 months (Jan- Jun 2014) we evaluated100 (54 boys, mean age 7,48±0.53 and 46 girls, meanage 7.66±0.64) children admitted for asthma attack. Adetailed natural history, disease summary, pulmonaryfunction test, bronchodilation test and anthropometricdata were gathered, as well as data for a control groupof 132 patients with acute respiratory infectionsmatched by age and sex.Results49 asthmatic patients have been using ICS (18 for morethan 5 years). There were not any significant correlationsbetween height, weight, BMI (SDS) and the ICStreatment period, the time without controller therapy,BDR response, birth weight, the asthma duration, familyhistory or atopy status (p>0,05, r 0,01-0,2). No differenceswere found in height SDS when the kids werestratified according ICS treatment and its duration (lessor over 5 years)(p>0,1), the same results came for weight(p>0,1) and BMI (p>0,1). Comparing with the controlgroup, there is not a significant difference in weight(p=0,07 asthma vs controls, p=0,15 asthma on ICS vscontrols), height (p=0.06 asthma on ICS vs. controls).Severe asthma patients (11 on high dose combined corticosteroids± montelucast) also don’t show any significantdifference in height, BMI and weight compared toother asthma patients (p>0,5). Long-term not treatedasthmatics also don’t have any significant difference inanthropometric data compared to other asthmatics.ConclusionLong-term ICS therapy or not proper treatment is not thatdetermining for height and weight status in asthmapatients. Interesting future study would determinewhether there is a correlation between different food behaviorand exercise pattern that could lead the previouslypublished data.