The Effect of Inhaled Corticosteroids on Insulin Resistance in Prepubertal Children with Asthma

Abstract

Purpose: Asthma is a chronic disease that causes frequent hospital admissions, medication use and impaired quality of life. The purpose of this study was to investigate the effect on insulin resistance of ICS in children with asthma using ICS in the prepubertal period. Materials and Methods: Asthmatic children receiving at least one month of maintenance asthma treatment and healthy children were included in the study. Patients’ fasting glucose, fasting insulin, BMI, and homeostasis model assessment insulin resistance (HOMA-IR) values were compared. Results: Two hundred twenty individuals were included in the study, 117 asthmatic and 103 healthy children. The children with asthma were divided into two groups depending on the maintenance treatment received-ICS (n=60) and montelukast (n=57). The median total cumulative inhaled corticosteroid doses were 40 mg (7.75-1090) in the ICS group and 3.75 mg (0-50) in the montelukast group (p<0.01). The groups’ fasting glucose, fasting insulin, and HOMA-IR levels were similar. It has been revealed no statistically significant relationship between fasting glucose, fasting insulin, BMI, IgE, or the skin prick test and corticosteroid doses in the ICS group. However, a positive correlation was found between HOMA-IR and maintenance cumulative and total cumulative corticosteroid doses (p=0.017). Conclusion: A positive correlation was determined between the cumulative amount of corticosteroid used by children with asthma and insulin resistance. We think that prolonged and high-dose corticosteroid use by children with asthma will cause insulin resistance.

Keywords

• cumulative corticosteroid dose
• fasting glucose
• fasting insülin
• homeostasis model assessment insulin resistance (homa-ir)
• montelukast