Retrospective Evaluation of the Effect of Long-term Use of Inhalation Glucocorticosteroids on Physical Development of Children and Adolescents with Bronchial Asthma

Abstract

The aim of research was to evaluate retrospectively the dose-depended effect of the use of inhaled steroids on the anthropometrical indices of children and adolescents with bronchial asthma.Material and methods. Based on the pulmonological department of the Regional children clinical hospital in Chernivtsi city there has been conducted the evaluation of the physical development of 50 asthma patients who were under long-term use of inhaled glucocorticosteroids (IGCS). All patients underwent anthropometric study: weight and height measurements with calculation of body mass index (BMI). The assessment of physical development of patients has been performed by a centile method, taking into account the age of patients (using percentile tables anthropometric indices to age ).Results. Analysis of the data has showed that a patients height was, on average, 50±4.4 percentile, which was corresponding to the average age-related normative values. At the same time height below (10-25 percentiles) average regarding to the age was recorded in 12 % of all examined patients, but an low (5-10 percentile) or very low (l5 percentiles) height were noted in only 4 patients (6 % and 2 % respectively among all patients). Meanwhile, it has been found that the average BMI in the examined patients was 20.4±0.5 kg/m2, which was corresponding to the normostenic structure. Simultaneously, only 5 of examined patients (10 %) were overweight (BMIg 25 kg/m2), and only one person out them (2 %) had clinically significant (BMIg 30 kg/m2) obesity.Conclusion. From the perspective of evidence-based medicine, negative impact of the long-term use of IGCS, in medium-high or high doses as well, on growth and body weight of the asthmatic children and adolescents had not been confirmed. At that, statistically significant data on the association of obesity and short stature with prolonged use of medium-high or high doses of IGCS had not been found: the attributive risk of excessive (body mass indexg 25 kg/m2) body weight was 24 %, the odd ratio=3.2 (95 % confidence interval: 0.33-30.94), but at the same time the attributive risk of short stature (height l10 percentiles): was 18 % and the odds ratio=2.3 (95 % confidence interval: 0.22-23.88)