Medicine of the Future in America

Decreased Bone Mineral Density in Premenopausal Asthma Patients Receiving Long-term Inhaled Steroids: Results

Decreased Bone Mineral Density in Premenopausal Asthma Patients Receiving Long-term Inhaled Steroids: ResultsThirty patients were recruited for the study. Their demographic and clinical data are shown in Table 1, and details of steroid use are shown in Table 2. Of the 30,17 had never received systemic steroids, while the other 13 had a medical history of some systemic steroid use in the past, within the limits as defined by the inclusion criteria previously mentioned. Their age, sex, BMI, and menstrual status were similar to those of the control group. All of these patients were fully ambulatory carrying on an independent active lifestyle. Their mean dietary calcium intake was 536 mg/d, which was similar to that of the healthy population in the comparable age range in Hong Kong at about 500 mg/d.
The total body bone mineral content was similar to that in control subjects, but the BMD of the lumbar area of the spine (L2-4), neck of the femur, trochanter major, and Ward’s triangle were all significantly lower than that of the matched control subjects (Table 3). There was no statistical difference between the 13 and 17 patients with and without a history of systemic steroid use. However, when male patients were distinguished from female patients, the decrease in BMD between patients and control subjects was predominantly seen only in the female group: neck of femur, p=0.049 (Fig 1); trochanter of femur, p=0.17; Ward’s triangle, p=0.029 (Fig 2); and lumbar area of the spine, p=0.039 (Fig 3). There was no significant difference between male patients and matched control subjects. There was no statistical difference between male and female patients with regard to age, BMI, cumulative dose, average daily dose, duration of use of inhaled steroids, and proportion of patients with a history of systemic steroid use. In the whole patient group, significant correlation was found positively between BMI and the BMD of the lumbar area of the spine (p=0.02) and the trochanter of femur (p<0.02), and negatively between age and BMD of Ward’s triangle (p<0.03). However, correlations with similar correlation coefficients could be seen in the analysis of the data from normal control subjects as well. allergy medications

Table 1—Demographic and Clinical Data

Data Patients
Male:female ratio, No. 12:18
Age, yr 32.5 ±9.0
BMI 21.1 ±3.24
Duration of asthma, yr 14.7 ±8.90

Table 2—Details of Steroid Use

Topical steroids
BDP, No. of patients
Bronchial 17
Nasal 9
BUD, No. of patients
Bronchial 24
Nasal 8
Duration of use, mo 40 ± 43.1 (3-180)
Cumulative dose per person, mg (BDP=BUD) 932 ±1,023 (142-3,242)
Average daily dose, /xg (BDP=BUD) 1,100±510 (200-2,400)
Nasal steroids, No. patients 14
Systemic steroids, No. patientsf 13

Table 3—Bone Densitometry Data

Bone Data Patient Control Subject Probability t
Total body bone mineral content, g 2,224 (1,686-3,494) 2,241 (1,786-3,025) NS
Spine BMD, g/cm2 (L2-4) 0.944 (0.707-1.168) 1.011 (0.811-1.376) 0.041
Hip BMD, g/cm2
Neck of femur 0.769 (0.607-1.144) 0.835(0.680-1.072) 0.007
Trochanter 0.676 (0.496-1.020) 0.724 (0.533-0.929) 0.034
Ward’s triangle 0.729 (0.505-1.068) 0.839 (0.497-1.180) 0.016

Figure-1

Figure 1. Comparison of BMD (z score) of the lumbar area of the spine (L2-4) in 18 female patients and matched control subjects.

Figure-2

Figure 2. Comparison of BMD (2 score) of neck of femur in 18 female patients and matched control subjects.

Figure-3

Figure 3. Comparison of BMD (z score) of Ward’s triangle of femur in 18 female patients and matched control subjects.

This entry was posted in Asthma and tagged asthma, inhaled steroid, systemic steroids.
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