Childhood asthma prevalence is markedly increasing in developing countries. The first line of treatment for asthma according to National asthma guidelines is inhaled corticosteroids (ICS). Accurate analysis of body composition for children with persisted asthma controlled by steroid therapy is essential as the potential effects related to the long-term use of this treatment are still a matter of concern. Aim: The purpose of this study was to assess the total and segmental body composition especially the lean body mass in Egyptian children with asthma receiving inhaled steroid therapy. Methods: Lean body mass was measured by the gold standard, dual-energy X-ray absorptiometry (DEXA) in a cross-section study of 130 Egyptian prepubertal school-aged children (4-12 years); 50 asthmatic children with long-term steroid therapy (for two years) and results were compared with lean body mass values of 50 healthy children.
Also, 30 asthmatic children with short-term steroid therapy (less than 6 months) were examined to rule of the duration therapy effect. Results: Asthmatic children received long-term steroid therapy had significantly higher chest lean mass than healthy children. Lean chest masse was found to have high associated with weight, height, body mass index (BMI), total lean mass and total fat mass. However, no statistical significance is detected with short-term steroid therapy. Also, there is no significant sex difference.
The lean chest mass is increased in children with asthma controlled by long-term steroid therapy, evaluation of those children using DEXA provides an accurate analysis of both total and segmental body composition. Keywords: lean body mass, DEXA, asthma, steroids Introduction Asthma is the most common chronic inflammatory lung disease in children. It is characterized by airway inflammation with episodes of coughing, wheezing, and shortness of breath [3]. Proper diagnosis of asthma is important to determine the best treatment and its dose. Asthma cannot be cured, but it can be controlled by medications that relieve its symptoms and prevent its acute attacks. Inhaled corticosteroids (ICSs) are used as long-term controllers to reduce asthma-related morbidity and mortality and improve quality of life.
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National guidelines recommend corticosteroid therapy as a standard treatment for long-term control of childhood asthma. Hence, the effects of long-term ICS therapy on children with asthma must be clearly defined. Analysis of body composition is essential for clinical and research settings [8]. Although the majority of studies on asthma have focused on obesity and used body mass index (BMI) as a fat indicator, its results reflect BMI limitation to predict body fatness and health risks in children; BMI cannot differentiate between muscle and fat mass as well as bone mineral content (BMC), also it cannot measure fat distribution but only indicate fatness in the whole body. Alternatively, measurement of body composition by dual energy x-ray absorptiometry (DEXA) provides an accurate assessment at the tissue level.
Careful consideration of the body composition changes and differentiation between fat and lean body mass may be an important factor in examining the lung functions in asthmatic children. The aim of this study was to assess the total and segmental body composition especially the lean body mass in Egyptian children with asthma receiving inhaled steroid therapy.
Cross section data were collected and reported in this manuscript. Results The present study includes three groups: children with asthma controlled by long-term steroid therapy (32 males and 18 females), healthy children (26 males and 24 females) and children with asthma used short-term steroid therapy (9 males and 21 females). Their mean age of both groups is 8.5 ± 3.0 SD. Regarding the frequency distribution of BMI; the asthmatic group of long-term steroid therapy included (42 of normal weight and 8 overweight and obese), while the asthmatic group of short-term steroid therapy included (24 of normal weight and 6 overweight and obese) and the healthy group included (43 normal weight and 7 overweight and obese). The means and standard deviations (SD) of the anthropometric measurements and significant body compositions values (lean mass and fat mass) of asthmatic with long-term steroid therapy and healthy group showed in (Table 1), while between asthmatic with long-term versus short-term steroid therapy shown in (Table 2). These data indicated that weight and BMI were significantly higher in asthmatic patients with long-term steroid therapy compared with the healthy group. Also, the chest lean mass had significantly higher in the asthmatic group with long-term steroid therapy.
