Bone ultrasonometric features and growth hormone secretion in asthmatic patients during chronic inhaled corticosteroid therapy

Mario Malerba, Simonetta Bossoni, Alessandro Radaeli, Erica Mori, Giuseppe Romanelli, Claudio Tantucci, Andrea Giustina, Vittorio Grassi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Quantitative ultrasound bone densitometry (QUBD) is a new method to assess bone mineral density and bone microarchitecture. Corticosteroid (CS) therapy may diminish bone mass, alter bone quality and may influence growth hormone (GH) secretion and bone metabolism markers. Therefore, the aim of this study was to evaluate the effects of long-term therapy with inhaled CSs (ICSs) on structural bone characteristics and their correlations with GH secretion and bone markers in asthmatic patients. Methods: In a cross-sectional study, we enrolled 60 adult patients with mild to moderate persistent asthma: 22 on chronic (>1 year) ICS therapy, 10 naive to ICSs treatment and 28 healthy control subjects. The groups were matched for age and BMI. Each subject underwent to QUBD at the phalanxes to assess bone microarchitecture by ultrasound bone profile index (UBPI), bone density by amplitude-dependent speed of sound (AdSos); test with GH-releasing hormone (GHRH) injection with calculation of peak GH and the Δ GH (peak GH-basal GH); and hormonal and bone markers measurements. Results: Asthmatics treated with long-term ICS therapy showed a lower UBPI (P < 0.01) compared to controls (49.8±19.3 vs. 77.0±10.1, respectively) and to asthmatics never taking ICSs (73.2±9.6). In ICS-treated asthmatics, ΔGH and GH-peak showed a significant correlation with UBPI. A significant difference was observed comparing asthmatics treated with ICSs to controls and asthmatics naive to ICSs in GH response to GHRH iv bolus. Serum osteocalcin was significantly reduced in asthmatic patients treated with ICSs. Conclusions: In asthmatic patients, long-term ICSs treatment produces negative effects on bone quality assessed by QUBD, and such effects are associated to an impaired GH secretion.

Original languageEnglish
Pages (from-to)119-124
Number of pages6
JournalBone
Volume38
Issue number1
DOIs
Publication statusPublished - Jan 2006
Externally publishedYes

Keywords

  • Asthma inhaled corticosteroids
  • Growth hormone
  • Quantitative bone ultrasound densitometry

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