Osteocalcin, growth, and inhaled corticosteroids: a prospective study.

OBJECTIVES To determine the relationship between biochemical markers of bone metabolism and statural growth, and their suitability as surrogate markers of inhaled corticosteroid induced growth suppression. DESIGN Randomised, double blind, placebo controlled comparison of inhaled beclomethasone dipropionate 200 micrograms twice daily as dry powder for six months. SETTING Southampton. OUTCOME MEASURES Serum osteocalcin, urinary deoxypyridinoline, and statural growth. SUBJECTS 7 to 9 year old children with recurrent wheeze. RESULTS There were no significant differences in serum osteocalcin between the beclomethasone dipropionate and placebo group measured at baseline or after three and six months' treatment, while deoxy-pyridinoline was significantly higher in the placebo treated children after three months. Growth was significantly decreased in the beclomethasone dipropionate group over the course of the study. Growth over the six months, both in those receiving beclomethasone dipropionate and those receiving placebo, was significantly correlated with serum osteocalcin measured at three months and six months. CONCLUSION Although serum osteocalcin shows excellent correlation with growth, it is a poor marker for decreased growth associated with use of inhaled corticosteroids.