Author : M. Ahmad, Muna
Annals of the College of Medicine, Mosul,
Volume 38, Issue 2, Pages 80-86
Objectives: To examine the prevalence of osteoporosis in steroid dependent asthma. To compare it with non-asthmatic patients who use steroid for different diseases and with a third group of patients who were referred for dual-energy X-ray absorptiometry (DXA) for various complaints and they never used steroid.
Patients and methods: The study involved 70 asthma patients (12 males and 58 females) on oral corticosteroids and /or inhaled steroid, with their mean age of 48.94 with SD±13.49, 40 non asthmatic patients (3 males and 37 females) on oral steroid with their mean age of 53.93 with SD±13.02 and 47 patients as control one male and 46 females who are neither asthmatic nor using steroids, their mean age of 52.47 with SD±9.76. All patients and controls were studied in the outpatient department in Ibn Sena Teaching Hospital. All patients and controls had their bone mineral density (BMD) measurement done by using dual-energy x-ray absorptiometry (DXA).
Results: The effects of weight on the development of osteopenia or osteoporosis indicate no statistically significant effects on the development of osteopenia or osteoporosis. The doses of steroids in osteoporotics showed no statistically significant difference between asthmatics and non-asthmatics. In osteopenia in both groups indicates statistically significant differences between them in favour of asthmatics over non-asthmatics. The duration of treatment with steroids for asthmatics and non-asthmatics indicates that, in osteoporotics asthmatics and non-asthmatics there were statistically significant difference between them, in favour of asthmatics over non-asthmatics, so as in osteopenics. Patients with asthma who take inhaled steroid only, indicates that the higher dose of inhaled steroids lead to osteoporosis with statistically significant difference between those who developed osteopenia or osteoporosis.
We compared the DEXA scan score values (T-scores and Z-score values) of asthmatics and nonasthmatics in the entire sample in this study. There were statistically significant differences between asthmatics and non-asthmatics (including the controls) with p-value for the T-scores and Z-score of (0.000, 0.000) respectively.
Conclusion: asthma should be regarded as independent risk factor for the development of osteopenia and osteoporosis. Steroid dose should be monitored. Adequate vitamin D supplement as preventive measures is well recognized factor in osteoporosis and osteopenia of all causes.