Body Composition and Growth in Asthmatic Children Treated with Inhaled Steroids

Background: Prolonged treatment with inhaled steroids is recommended for long-term control of asthma in children; however, it can interfere with growth and body composition. Objective: The aim of this study is to answer the question whether 6 months treatment with inhaled steroids causes body fat accumulation and growth velocity reduction. Methods: Hospital-based, open study of body composition [by dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA) and skinfolds] and growth of 26 asthmatic children, treated for 6 months with inhaled steroids [budesonide (BUD) 400 μg/day (group 1) or fluticasone proprionate (FP) 200 μg/day (group 2)], sodium cromoglycate and β2-agonist (salbutamol) compared with a control group of 16 asthmatic children treated only with sodium cromoglycate and β2-agonist. Results: On average, total and regional fat mass, adjusted for pubertal stage and gender, and growth velocity were similar in all three groups of patients and were not influenced by treatment (% mean change ± 1 SD of fat mass during treatment in BUD 0.1 ± 3.0%, FP -1.1 ± 3%, and control -28. ± 3.5%; ANOVA ≥ .05); however seven patients, two in group 1 (1 preschool child), three in group 2 (2 preschool children) and two in the control group (two prepubertal boys aged 8.5 and 9.5 year), during treatment, showed a growth velocity standard deviation score below the third percentile. Conclusion: A 6-month treatment with inhaled BUD and FP does not induce body fat accumulation; however, in a few preschool children the treatment was associated with growth velocity below the third percentile. Our results suggest the need for constant monitoring of growth in all asthmatic children on chronic treatment with inhaled steroids. Further studies devoted to the effects of inhaled steroids use in preschool children are needed. Ann Allergy Asthma Immunol 2000;85:221-226.