Premenopozal D�nemdeki Ast�ml� Hastalarda �nhale Kortikosteroidlerin Kemik Mineral Yo�unlu�u, Kemik Yap�m ve Y�k�m Belirte�leri ile Ya�am Kalitesi �zerine Etkileri

At�c�, Arzu; Cerraho�lu, Lale; �elik, P�nar; Uyan�k, Bekir Sami

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Premenopozal D�nemdeki Ast�ml� Hastalarda �nhale Kortikosteroidlerin Kemik Mineral Yo�unlu�u, Kemik Yap�m ve Y�k�m Belirte�leri ile Ya�am Kalitesi �zerine Etkileri [Bosphorus Med J]

Bosphorus Med J. 2023; 10(1): 13-18 | DOI: 10.14744/bmj.2022.33254

Premenopozal D�nemdeki Ast�ml� Hastalarda �nhale Kortikosteroidlerin Kemik Mineral Yo�unlu�u, Kemik Yap�m ve Y�k�m Belirte�leri ile Ya�am Kalitesi �zerine Etkileri

Arzu At�c�¹, Lale Cerraho�lu², P�nar �elik³, Bekir Sami Uyan�k⁴
¹Sa�l�k Bilimleri �niversitesi, Fatih Sultan Mehmet E�itim ve Ara�t�rma Hastanesi, Fiziksel T�p ve Rehabilitasyon Klini�i, �stanbul, T�rkiye
²Celal Bayar �niversitesi, Fiziksel T�p ve Rehabilitasyon Anabilim Dal�, Manisa, T�rkiye
³G��s Hastal�klar� Anabilim Dal�, Celal Bayar �niversitesi, Manisa, T�rkiye
⁴Biyokimya ve Klinik Biyokimya B�l�m�, Hisar K�talararas� Hastanesi, �stanbul, T�rkiye

G�R�� ve AMA�: Bu �al��mada, ast�ml� hastalarda inhale kortikosteroidlerin kemik mineral yo�unlu�u (KMY), kemik yap�m ve y�k�m belirte�leri ile ya�am kalitesi �zerine etkisinin ara�t�r�lmas� ama�land�.
Y�NTEM ve GERE�LER: Bu kesitsel �al��maya ast�m tan�s� alm��, en az �� ayd�r d�zenli inhale kortikosteroid kullanan premenopozal d�nemdeki kad�n hastalar dahil edildi. Kontrol grubu olarak ast�m� olmayan ve daha �nce kortikosteroid kullanmam�� premenopozal d�nemdeki kad�n bireyler �al��maya al�nd�. Kemik yap�m ve y�k�m belirte�leri olarak serum kemi�e spesifik alkalen fosfataz (BAP), osteokalsin ve beta crosslaps d�zeyleri incelendi. Lomber vertebra L2-L4 anterior, sol femur boynu ve kal�a toplam KMY, T ve Z skorlar� �l��ld�. Hastalar�n ya�am kalitesini de�erlendirmek i�in K�sa Form 36 (SF-36) ya�am kalitesi �l�e�i kullan�ld�.
BULGULAR: �al��maya 22 ast�ml� hasta, kontrol grubu olarak da ast�m� olmayan 22 birey dahil edildi. Her iki grup aras�nda L2-L4 anterior, femur boynu ve kal�a toplam KMY, T ve Z skorlar� aras�nda ve serum osteokalsin, beta crosslaps ve BAP seviyelerinde istatistiksel olarak anlaml� farkl�l�k saptanmad� (p>0,05). Ast�ml� hastalar�n hastal�k y�l�, inhale kortikosteroid kullan�m s�resi ve k�m�latif inhale kortikosteroid dozuyla KMY aras�nda istatistiksel olarak anlaml� korelasyon saptanmad� (p>0,05). Ast�ml� hastalarda kontrol grubuna g�re SF-36 ya�am kalitesi �l�e�i a�r� puan� istatistiksel olarak anlaml� daha y�ksek bulundu (p<0,05). SF-36 ya�am kalitesi �l�e�inin di�er alt �l�ek-lerinde ise anlaml� farkl�l�k saptanmad� (p>0,05).
TARTI�MA ve SONU�: �al��mada, inhale kortikosteroidlerin KMY ile kemik yap�m ve y�k�m belirte�leri �zerine etkisi saptanmad�. Ast�ml� hastalarla kontrol grubu aras�nda SF-36 ya�am kalitesi �l�e�inde a�r� d��ndaki parametrelerde farkl�l�k tespit edilmemesi de ast�ml� hastalarda inhale kortikosteroidlerin ya�am kalitesi �zerine olumlu etkisi olabilece�ini d��nd�rmektedir.

Anahtar Kelimeler: Ast�m, inhale kortikosteroidler, kemik mineral yo�unlu�u.

The Effects of Inhaled Corticosteroids on Bone Mineral Density, Bone Formation/Resorption Markers, and Quality of Life in Premenopausal Asthmatic Women

Arzu At�c�¹, Lale Cerraho�lu², P�nar �elik³, Bekir Sami Uyan�k⁴
¹Department of Physical Medicine and Rehabilitation, University of Health Science, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, T�rkiye
²Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, T�rkiye
³Department of Chest Disease, Celal Bayar University, Manisa, T�rkiye
⁴Department of Biochemistry and Clinical Biochemistry, Hisar Intercontinental Hospital, Istanbul, T�rkiye

INTRODUCTION: We aimed to investigate the effects of inhaled corticosteroids (CS) on bone mineral density (BMD), bone formation-resorption markers, and quality of life in premenopausal asthmatic women.
METHODS: Premenopausal women diagnosed with asthma and using regular inhaled CS for at least 3 months were included in our cross-sectional study. As the control group, premenopausal women without a diagnosis of asthma and who had not used steroid before were included in the study. Serum bone-specific alkaline phosphatase (BAP), osteocalcin, and β crosslapse levels were evaluated as bone formation-resorption markers. BMD, T and Z scores of lumbar vertebra L2-L4 anterior, left femoral neck, and total hip were measured. The Short Form 36 (SF-36) quality of life scale was used to assess the quality of life.
RESULTS: Twenty-two asthmatic patients and 22 non-asthmatic individuals as a control group were included in the study. There was no statistically significant difference between L2-L4 anterior, femoral neck and total hip BMD, T and Z scores, and serum osteocalcin, β crosslaps, and BAP levels between both groups (p>0.05). No statistically significant correlation was found between the duration of inhaled CS use, cumulative inhaled CS dose, and BMD in asthmatic patients (p>0.05). SF-36 quality of life scale pain score was found to be statistically significantly higher in patients with asthma compared to the control group (p<0.05). No significant difference was found in the other subscales of the SF-36 quality of life scale (p>0.05).
DISCUSSION AND CONCLUSION: In our study, we did not find the effect of inhaled CS on BMD and bone formation and resorption markers. We did not find any difference between the asthmatic patients and the control group in the sub-parameters of the SF-36 quality of life scale, except for pain. This suggests that inhaled CS may have a positive effect on quality of life in patients with asthma.

Keywords: Asthma, bone mineral density, inhaled corticosteroids

Sorumlu Yazar: Arzu At�c�, T�rkiye
Makale Dili: T�rk�e

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