Penelitian sebelumnya telah mendokumentasikan efek kortikesteroid oral dan inhalan pada densitas mineral tulang pada orang dewasa, tetapi sedikit yang diketahui konsekuensi penggunaannya pada anak-anak, menurut Dr. H. William Kelly dkk.
Dr. Kelly dari University of New Mexico di Alburqueque, dan group beliau yang diikuti oleh 531 anak laki-laki dan 346 anak perempuan (usia antara 5-12 tahun, nilai tengah usia 16.6 thn saat terakhir follow up) yang menikuti prospective “Childhood Asthma Management Program”. Kortikosteroid oral diberikan dalam pemberian standar hingga 60 mg/hari selama 2 hari dan dilanjutkan hingga 30 mg selama 2 hari.
Peneliti mengamati efek dosis dependent kortikosteroid oral meledak pada pertambahan mineral tulang (p = 0.0002 for trend) dan hubungan peningkatan resiko oesteopenia (p = 0.02 for trend)di spina lumbal pada anak laki-laki.
Kostikosteroid inhalan juga berkaitan dengan pengurangan pertumbuhan mineral tulang pada anak laki-laki (p = 0.05 for trend), dan tidak menunjukkan dosis dependen ataupun berkaitan dengan resiko osteopenia.
Tidak ada hubungan yang signifikan antara kortikosteroid inhalan atau oral dengan pertumbuhan mineral tulang ataupun resiko osteopenia pada anak perempuan. Pengarang berspekulasi bahwa jumlah anak perempuan (yg mjd sampel, ed) dan efek protektif estrogen selama pubertas yang menjaga mereka dari terdeteksinya efek yang signifikan.
Pada kesimpulannya, Dr.Kelly dkk menuliskan ” Penggunaan kortikosteroid inhalan potensial mengurangi pertumbuhan mineral tulang pada anak laki-laki dan semakin bertambah selama masa pubertas, tetapi resiko ini lebih banyak keuntungannya daripada kerugiannya melihat kemampuannya mengurangi jumlah penggunaan kortikosteroid oral pada anak-anak ini”
Tulisan asli bisa di lihat disini :
http://www.medscape.com/viewarticle/578375?src=mp&spon=13&uac=78 
Multiple Short Courses of Oral Corticosteroids May Cause Osteopenia in Children
NEW YORK (Reuters Health) Jul 31 - Long-term, sustained use of inhaled corticosteroids is less likely than multiple short courses of oral corticosteroids to reduce bone mineral accretion and cause osteopenia in children with persistent asthma, particularly in boys, according to an article in the July issue of Pediatrics.
Previous research has documented the adverse effects of both oral and inhaled corticosteroids on bone mineral density in adults, but little is known about consequences of their use in children, Dr. H. William Kelly and colleagues note.
Dr. Kelly, at the University of New Mexico in Albuquerque, and his group followed 531 boys and 346 girls (ages 5-12 years at baseline, median age 16.6 years at last follow-up) enrolled in the prospective Childhood Asthma Management Program. Oral corticosteroids were administered in standard courses of up to 60 mg/day for 2 days, followed by up to 30 mg for 2 days.
The investigators observed a dosage-dependent effect of oral corticosteroid bursts on bone mineral accretion (p = 0.0002 for trend) and an associated increased risk for osteopenia (p = 0.02 for trend) in the lumbar spine of boys.
Inhaled corticosteroids were also associated with a small reduction in bone mineral accretion in boys (p = 0.05 for trend), which did not appear to be dosage dependent or associated with osteopenia risk.
There were no significant associations between oral or inhaled corticosteroids and bone mineral accretion or risk of osteopenia in girls. The authors speculate that the smaller number of girls and the protective effects of estrogen during puberty kept them from detecting any significant effects.
In conclusion, Dr. Kelly and his associates write, "Inhaled corticosteroid use has the potential for reducing bone mineral accretion in male children progressing through puberty, but this risk is likely to be outweighed by the ability to reduce the amount of oral corticosteroids used in these children."
Pediatrics 2008;122:e53-e61.
