Attained adult height after childhood asthma: Effect of glucocorticoid therapy,☆☆,,★★

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Abstract

Background: Although oral and inhaled glucocorticoid therapy may impair growth in children with asthma, the effect of glucocorticoid therapy and asthma on attained adult height has not been extensively studied in representative children in the community. Objectives: The study was designed to compare the attained adult height of children with asthma with the attained adult height of nonasthmatic children and to compare the attained adult height of asthmatic children treated with glucocorticoids with the attained adult height of asthmatic children who did not receive glucocorticoids. Methods: Residents of Rochester, Minnesota, with onset of asthma from 1964 to 1987 and age- and sex-matched nonasthmatic residents of Rochester were studied. Glucocorticoid exposure was assessed from medical records. The mean of 5 stadiometer measurements of adult height, adjusted for sex and parental height, was analyzed. Results: One hundred fifty-three patients with asthma (mean age at onset, 6.1 ± 4.8 years) and 153 age- and sex-matched nonasthmatic subjects were studied. Adult height of patients with asthma (mean age at measurement, 25.7 ± 5.2 years) was not significantly different from the adult height of nonasthmatic subjects; the overall difference, adjusted for mid-parental height, was –0.20 cm (95% confidence interval from –0.27 to 1.64). The adult height of asthmatic children treated with glucocorticoids was not significantly different from the adult height of patients with asthma not treated with glucocorticoids; the difference after adjusting for mid-parental height was –0.2 cm (95% confidence interval from –0.1 to 0.6). Conclusions: We conclude that the attained adult height of patients with asthma is not different from the adult height of age- and sex-matched nonasthmatic subjects and that the attained adult height of asthmatic children treated with glucocorticoids is not significantly different from the adult height of children not treated with glucocorticoids. (J Allergy Clin Immunol 1997;99:466-74.)

Section snippets

Study setting

Rochester, Minnesota, is located 90 miles southeast of Minneapolis and is centrally located in Olmsted County. In 1990 the population of Rochester was 70,745 (94% white). With the exception of a higher proportion of residents employed in the health care industry, the characteristics of Rochester are similar to those of the U.S. white population. Population-based epidemiologic research is possible in this setting because essentially all medical care for Rochester residents is provided by the

Results

At the time the study was initiated, 778 members of the updated asthma cohort had experienced onset of asthma during childhood and had attained adult height (age 17 in girls and age 19 in boys) and were therefore eligible for the study. Fifty-six members of the original cohort were excluded because of unavailable current addresses (37 cases), revised diagnoses (4 cases), deaths (2 cases), or other miscellaneous reasons (13 cases). The remaining 722 Rochester residents with onset of asthma

Discussion

This study used a population-based incidence cohort of patients with asthma as a sampling frame to enroll subjects with onset of asthma before attaining adult height. The adult height of patients with asthma, adjusted for parental height, was not significantly different from the height of nonasthmatic subjects, suggesting that, overall, asthma does not have an important effect on attained adult height. The attained adult height of patients with asthma who received glucocorticoids was not

Acknowledgements

We thank Joanne Mair, RN, and Judy Blomgren, RN, for their untiring effort in recruiting eligible members of the original asthma cohort and age- and sex-matched nonasthmatic residents of Rochester, Minnesota, for the study. We also thank Lee Bellrichard, RN, and Mary Lou Notermann, RN, for reviewing the subjects' medical records.

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  • Cited by (0)

    From athe Division of Area General Internal Medicine, bthe Department of Health Sciences Research, cthe Department of Pediatric and Adolescent Medicine, and dthe Division of Allergic Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester.

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    Supported by a grant from Schering-Plough Research, a grant from the National Institutes of Health (AI-25187), and the Mayo Foundation.

    Reprint requests: Marc D. Silverstein, MD, Center for Health Care Research, Medical University of South Carolina, 171 Ashley Ave., Charleston, SC 29425.

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