Influence Of Long-term Middle And Low Dose Inhaled Corticosteroids On The Prepubertal Growth Of Children With Mild To Moderate Asthma

Objective:The purpose of this study is to discuss the effects of long-term inhaled corticosteroids at low and middle dose on growth in children with mild to moderate asthma as well as the superiority of long-term ICS treatment for children with asthma control,and to provide reference for guiding the prevention and treatment of asthma for improving the level of asthma control.Methods:1.A total of 173 prepubertal children aged 3 to 9.5 years from asthma clinic in our hospital from January 2016 to February 2017 were enrolled for the analysis of the retrospective investigation,in which 80 asthmatic children had received at least 12-months ICS treatment at low and middle dosage;93 asthmatic children had received ICS treatment at low and middle dosage less than 12-months,or had yearly received any dose,dosage form of glucocorticoid treatment for no more than 2 months;50 were healthy control.When they enrolled,their height and weight were measured by professionals.The height standard deviation(SDS)was used as the main evaluation index in order to reduce the influence of age,gender and regional factors on growth.2.Guardians should complete a questionnaire which includes respondents' demographic characteristics,height and weight of one year ago,activities,maternal education,family income,previous asthma onset and control and ICS use and dose.3.One-way analysis of variance and Kruskal-Wallis H test was used to analyze the difference of height SDS,growth velocity(GV)between the three groups;and linear regression analysis was used to analyze the correlation between the factors and height index in ICS long-term treatment group.Results:1.There was no significant difference in height SDS at enrollment among the three groups(0.05±0.98 vs 0.04±0.86 vs 0.05±0.65,F=0.242,P=0.785).In the ICS long-term treatment group,height SDS at enrollment was positively correlated with weight SDS as well as family income,and growth velocity was positively correlated with growth rate of weight,family income,father'heights,and was negatively correlated with age.2.Growth velocity in ICS long-term treatment group was lower than that of ICS non long-term treatment group(Z=-2.913,P=0.0.004),but no difference was found when compared with controls(Z=-0.301,P=0.764).3.No difference was found in the frequence of average asthma exacerbations between the ICS long-term treatment group and the ICS non-long-term treatment group(P=0.385),but the number of hospitalization and emergency visits due to asthma were lower in the former than those of the latter(P=0.000,P=0.040).4.Linear regression analysis showed that the height SDS and growth velocity of ICS long-term treatment group were not correlated with the duration of ICS treament,the ICS dose and the inhalation device.Conclusion:1.Long-term treatment of ICS at low to middle dose had no significant effects on the growth of children with mild to moderate asthma,and is conductive for asthma control.2.The height of asthmatic children is associated with age,family,genetics,nutrition,and has nothing to do with ICS treatment duration,dose and inhalation devices.