Article Text
Abstract
Background Corticosteroids may inhibit growth hormone (GH) axis, reducing GH release, decreasing tissue expression of growth factors, inhibiting IGF-1 bioactivity, osteoblast activity, promoting bone resorption.
Objectives Evaluating adverse effects of inhaled corticosteroids used in asthmatic children on the following biological parameters: GH (two measurements), IGF-1(insulin growth factor-1), FAS (alkaline phosphatase), correlated with the presence or absence of atopy (immunoglobulin E levels).
Methods The prospective study included 74 asthmatic children, treated with inhaled corticosteroids aged between 5 and 13 years of age, divided into subgroups. Each type of inhaled glucocorticoid fluticasone, budesonide, mometasone furoate (single or in combination with long-acting bronchodilators) has been analysed for each patient. T-test, Mann-Whitney, Chi-square, binomial tests were used to ascertain the relations between average dose, the duration of treatment and the biological parameters mentioned .
Results There were found statistically significant differences (p<0.05) in:
patients treated with Seretide 25/50 between the number of patients with GH values < 1ng/ml and number of patients with GH > 1ng/ml (second measurement of GH).
patients treated with Symbicort 4.5/80, between the number of patients with GH values < 1ng/ml and number of patients with GH > 1ng/ml (first measurement of GH).
patients treated with Seretide 50/100 for the following parameters: GH (both determinations), IgE and FAS.
Conclusions Systemic effects of fluticasone propionate and budesonide formoterol in small and medium doses were noted in the association with long-acting bronchodilators and were more extensive accordingly to the duration of treatment.