Original Articles
Reduced height in Swedish men with asthma at the age of conscription for military service

https://doi.org/10.1067/mpd.2000.107384Get rights and content

Abstract

Objective: To investigate the influence of asthma on growth in Swedish children during a period when inhaled corticosteroids (ICS) have been first-line therapy for persistent asthma. Study design: We analyzed the height of conscripts with and without asthma in the year they turned 18 years old, using Swedish military conscription records from 1983, 1986, 1993, and 1996, and assessed exposure to ICS using prescription records over the same period. Result: The mean height for conscripts without asthma was 179.3 cm (SD = 6.6 cm, n = 164,503) and for conscripts with asthma 178.6 cm (SD = 6.6 cm, n = 8,531, P <.001). The severity of asthma had a negative correlation with height in all study populations (P <.001 in each year tested). Since 1985, increasing numbers of children with asthma have been treated with ICS in Sweden. Sales of ICS for males from birth to age 19 years increased from 68,000 daily doses in 1983 to more than 3,000,000 in 1995-1996. During this period, there was no statistically significant change in the height difference between conscripts with and without asthma. Conclusion: The introduction of inhaled steroids in Sweden, where budesonide is the predominant medication, has not changed the mean difference in heights between Swedish conscripts with and without asthma. (J Pediatr 2000;137:25-9)

Section snippets

Swedish conscription data

Sweden has compulsory military service; about 45,000 to 60,000 male Swedish citizens are called for mandatory conscription every year, usually during the year they turn 18 years old. Approximately 1,500 to 2,000 each year do not qualify for conscription for various reasons—for example, they live abroad, or are disabled or institutionalized. A standardized medical examination is performed at the conscription. We examined computerized conscription medical records for the years 1983, 1986, 1993,

Mean heights in conscripts with and without asthma

Of the 61,050 male Swedish citizens who turned 18 in 1983, 87% were conscripted that same year. Corresponding figures for the other years are 75% of 56,033 in 1986, 76% of 51,293 in 1993, and 83% of 46,869 in 1996. The mean height of Swedish conscripts with asthma for the years 1983, 1986, 1993, and 1996 combined was 178.6 cm (SD = 6.6 cm, n = 8,531) and without asthma was 179.3 cm (Std = 6.6 cm, n = 164,503). The minimum recorded height was 138 cm and the maximum was 213 cm. The mean height of

Discussion

In children with asthma, growth represents the sum effect of both asthma treatment and of asthma itself. The present data constitute the largest population-based assessment of asthma and height available. Furthermore, the period in the present study is unique in that it covers a time when inhaled steroids were introduced in asthma treatment.

This study demonstrates a relationship between height and both having the diagnosis of asthma and severity of asthma. It is obvious from the present study

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    Reprint requests: Ensio Norjavaara, AstraZeneca R & D Lund, 221 87 Lund, Sweden.

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