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Title: Growth and endocrine function in prepubertal children with asthma
Author: Crowley, Suzanne
ISNI:       0000 0001 3398 901X
Awarding Body: University of Southampton
Current Institution: University of Southampton
Date of Award: 1997
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I measured growth velocity over 12 months at three monthly intervals in 56 prepubertal children with well controlled asthma who were grouped according to treatment (13 non-steroid, 19 inhaled budesonide, 20 inhaled beclomethasone, 4 inhaled steroid and prednisolone). The results of the study showed that growth delay is a feature of asthma, irrespective of treatment, and is associated with reduced serum levels of the adrenal androgen dehydroepiandrosterone sulphate. Inhaled steroid treatment was associated with reduced linear growth velocity and this was more apparent in children taking beclomethasone dry powder compared with children taking budesonide through a nebuhaler. Increased oropharyngeal deposition and gastrointestinal absorption with the dry powder device may have accounted for this effect. The growth retarding effect of inhaled budesonide delivered through a nebuhaler was dose related and slow growth was likely in doses exceeding 1970 μg/m²/day. Growth rate correlated well with measures of adrenal gland function in particular, the rise in serum cortisol concentration in response to low-dose ACTH(1-24). Growth hormone (GH) secretion, serum IGF-1, IGF-1 bioactivity and IGF binding protein-3 were not affected by inhaled steroid treatment. However, the ratio of GH to its binding protein (BP) was reduced in children taking inhaled steroids and correlated with growth rate. GHBP correlated well with skinfold thickness, dietary intake of fat and carbohydrate and body mass index and may serve as a nutritional marker. There was a tendency for fasting levels of plasma insulin to be elevated by inhaled steroid treatment despite normoglycaemia. Types I and III collagen synthesis was reduced in children treated with inhaled steroids but type I collagen degradation appeared to be more active in non-steroid treated children and reduced by inhaled steroid treatment. These findings indicate that treatment of prepubertal asthmatic children with inhaled steroids may be accompanied by significant effects on growth, adrenal function and types I and III collagen metabolism.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Medicine