Original ArticlesReduced height in Swedish men with asthma at the age of conscription for military service☆
Section snippets
Swedish conscription data
Sweden has compulsory military service; about 45,000 to 60,000 male Swedish citizens are called for mandatory conscription every year, usually during the year they turn 18 years old. Approximately 1,500 to 2,000 each year do not qualify for conscription for various reasons—for example, they live abroad, or are disabled or institutionalized. A standardized medical examination is performed at the conscription. We examined computerized conscription medical records for the years 1983, 1986, 1993,
Mean heights in conscripts with and without asthma
Of the 61,050 male Swedish citizens who turned 18 in 1983, 87% were conscripted that same year. Corresponding figures for the other years are 75% of 56,033 in 1986, 76% of 51,293 in 1993, and 83% of 46,869 in 1996. The mean height of Swedish conscripts with asthma for the years 1983, 1986, 1993, and 1996 combined was 178.6 cm (SD = 6.6 cm, n = 8,531) and without asthma was 179.3 cm (Std = 6.6 cm, n = 164,503). The minimum recorded height was 138 cm and the maximum was 213 cm. The mean height of
Discussion
In children with asthma, growth represents the sum effect of both asthma treatment and of asthma itself. The present data constitute the largest population-based assessment of asthma and height available. Furthermore, the period in the present study is unique in that it covers a time when inhaled steroids were introduced in asthma treatment.
This study demonstrates a relationship between height and both having the diagnosis of asthma and severity of asthma. It is obvious from the present study
References (27)
- et al.
Decrease in hospitalization for treatment of childhood asthma with increased use of antiinflammatory treatment, despite an increase in the prevalence of asthma
J Allergy Clin Immunol
(1996) - et al.
Effects of long term treatment with an inhaled corticosteroid on growth and pulmonary function in asthmatic children
Respir Med
(1994) - et al.
Growth in asthmatic children treated with fluticasone propionate
J Pediatr
(1998) - et al.
A meta-analysis of the effect of oral and inhaled corticosteroids on growth
J Allergy Clin Immunol
(1994) - et al.
Maturational delay and temporal growth retardation in asthmatic boys
J Allergy Clin Immunol
(1977) - et al.
Attained adult height after childhood asthma: effect of glucocorticoid therapy
J Allergy Clin Immunol
(1997) - et al.
Continued decrease in hospitalization for asthma in school children but not in young children with increased use of inhaled corticosteroids [abstract]
J Allergy Clin Immunol
(1999) - et al.
Inhaled corticosteroids and the prevention of readmission to hospital for asthma
Am J Respir Crit Care Med
(1998) - et al.
First treatment with inhaled corticosteroids and the prevention of admissions to hospital for asthma
Thorax
(1998) - et al.
One year treatment with salmeterol compared with beclomethasone in children with asthma
Am J Respir Crit Care Med
(1997)
A comparison of beclomethasone, salmeterol, and placebo in children with asthma
N Engl J Med
Growth during one year of treatment with fluticasone propionate or sodium cromoglycate in children with asthma
Pediatr Pulmonol
Systemic effects of inhaled corticosteroids on growth and bone turnover in childhood asthma: a comparison of fluticasone with beclomethasone
Eur Respir J
Cited by (39)
Inhaled corticosteroids in children: Effects on bone mineral density and growth
2014, The Lancet Respiratory MedicineCitation Excerpt :Whether this temporary reduction in growth velocity would eventually result in a permanent decrement in adult height was not established by these study findings, as shown by the required standardised labelling of these drugs: “The long-term effects of this reduction in growth velocity associated with [orally inhaled/intranasal] corticosteroids, including the impact on final adult height, are unknown.”5 Investigators of most cross-sectional retrospective cohort studies10–14 in adults reported no differences in target heights between patients with asthma who received inhaled corticosteroids as children and age-matched and sex-matched controls (either patients with asthma who had not received inhaled corticosteroids, or controls without asthma). However, findings from one study10 showed a significantly lower difference for adult height minus target height in adults who received inhaled corticosteroids as children than for those with asthma who had never received the drugs, despite no differences in mean adult height or height standard-deviation scores.
Normal and Aberrant Growth
2011, Williams Textbook of Endocrinology, Twelfth EditionUntreated asthma, final height and sitting height/leg length ratio in Chile
2006, Respiratory MedicineAdult asthma severity in individuals with a history of childhood asthma
2005, Journal of Allergy and Clinical ImmunologyCitation Excerpt :A modest negative correlation between inhaled corticosteroid use and percentile height existed only at the start of the original clinical trial (r = −0.27; P = .02). No other significant correlations between stature and oral and/or inhaled corticosteroid usage in childhood were observed, consistent with previous published studies.17,18 In summary, we conclude that the degree of atopy is a major determinant of the prognosis of childhood allergic asthma in adulthood.
On the good usage of inhaled corticosteroids in asthmatic children
2004, Revue des Maladies Respiratoires
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