Evaluation of body composition parameters in asthmatic children receiving inhaled fluticasone propionate treatment

Asthma is a chronic inflammatory disease of the airways characterized by airway hyperresponsiveness against variable stimulus and airway obstruction. Inhaled corticosteroids control asthma symptoms, reduce asthma attacks, emergency department visits and enhance quality of life, respiratory function tests and bronchial hyperresponsiveness. Prolonged treatment with low doses of ICS in children does not seem to affect growth rate; however, limited data are currently available on the body composition parameters like percentage body fat and muscle mass. The purpose of this study is to examine whether treatment with inhaled corticosteroids has an effect on body mass index, percentage body fat, obesity degree, basal metabolic rate, body fat mass and muscle mass on children with asthma. 45 healthy children and 45 patients who aged between 4 to 9 years, received 250 mcg fluticasone propionate per day for at least 6 months and did not receive systemic corticosteroid treatment for more than ten days in last year and applied to the Faculty of Medicine, Baskent University Ankara Hospital Pediatric Allergy Clinic between February 2014-May 2015 were included in the study. 26 children had only one asthma attack and 19 children had more than one asthma attack in last year. 29 children had atopy. 31 children had mild and 14 children had moderate persistent asthma. Pulmonary function tests were performed with spirometry. Body Mass Index (BMI), Percentage Body Fat (PBF), Obesity Degree (OD), Basal Metabolic Rate (BMR), Body Fat Mass (FM) and Muscle (M) were performed with InBody 230-MW-160 and waist-hip circumference were measured in both healthy and asthmatic children. Written questionnaires on the duration of television/computer viewing, frequency of fast food consumption and weekly physical activity were completed by the parents/guardians of all children. When asthmatic children who received inhaled fluticasone propinate treatment for more than 6 months and healthy children were compared, there was no significant difference in body composition parameters and waist-hip cicumference measurements. Positive correlation was demonstrated between the duration of inhaled corticosteroid treatment and each of these body composition parameters; PBF, muscle, fat mass and hip circumference. When children with asthma and healthy children were compared, significant increase in duration of television/computer viewing and frequency of fast food consumption; significant decrease in weekly physical activity were observed in asthmatic children. As a result, no statistically significant difference in PBF was found between children with asthma who received inhaled corticosteroids and healthy children. However, as the duration of treatment increased, PBF had increased. In future we suggest that long-term studies with larger patient population grups may explain effect of inhaled corticosteroids on body composition parameters more clearly. Keywords: basal metabolic rate (BMR), bioelectrical impedance analysis (BIA), body compositions, body fat mass (FM), body mass index (BMI), childhood asthma, InBody, inhaled corticosteroid, muscle (M), obesity degree (OD), percentage body fat (PBF).