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| |  DG DISPATCH - ATS: Does Steroid Use Really Affect Growth In Asthmatics? By Cameron Johnston Special to DG News
TORONTO, ONTARIO -- May 11, 2000 -- Many studies in the past have shown that asthmatics who use high-dose oral steroids over a long period of time may develop weak bones and possibly osteoporosis or osteopenia. New research now suggests that long-term inhaled steroid use does not really affect the final height for asthmatics. The findings came from two studies, from Sweden, which compared data on the heights of more than 287,000 pregnant women who were born between 1960-74 and the heights of more than 2,700 women, born during the same years, who were hospitalized for asthma complications. Compiling data of this nature was easy since virtually all pregnant women in Sweden have their height recorded as a matter of course, usually around the 10th week of pregnancy. The first portion of the study, conducted by Ensio Norjavaara, MD, of the Goteburg Pediatreic Growth Research Centre, in Goteburg, Sweden, found that women who have asthma, in general, were slightly shorter -- by 0.7 to 1.2 cm -- than non-asthmatic women. Since these women were born and were being treated for their asthma before the advent of inhaled corticosteroids, however, the difference in heights cannot be blamed on steroid use. Meanwhile, a second study, conducted by Lars Larsson, in the department of pulmonary medicine, at Ostersund Hospital, in Ostersund, Sweden, evaluated people born from 1974 and 1977 who reported any diagnosis of asthma. These people were divided into study subjects and controls. The analysis included 97 asthmatic patients who were treated either with inhaled or oral steroids -- for men, before their 20th birthday, and for women before their 18th birthday. They were compared with non-asthmatic controls, and asthmatics who had never used any kind of steroid. The study did not find a statistically significant difference in final height among those asthmatics who were either exposed to steroids and those who were not exposed to steroids, when compared with healthy non-asthmatic controls. Analyzing height data does, however, does not address the issue of osteoporosis and loss of bone mineral density among people who use steroids. Researchers are unable to predict whether steroid treated asthmatics will have some kind of residual effect whereby they lose height in later years faster than asthmatics who were not treated with steroids.
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