Study ties breathing problems, asthma to bone loss

NEW YORK - People with asthma-related breathing problems may be at increased risk for bone loss, according to a new study.

The study examined the records of more than 7,000 adults in Seoul, Korea, and found those with a certain characteristic of asthma had significantly lower bone density in a region of their spine than those without asthma symptoms.

The characteristic, called airway hyperresponsiveness, means the airways in the lungs are particularly sensitive, and it doesn't take much to trigger an asthma attack.

However, both men and women with airway hyperresponsiveness were still in the normal range for overall bone density, on average. And researchers couldn't say whether the asthma symptoms or the bone loss came first or what linked the two.

"Asthma could be a risk for bone loss. The degree to which their disease puts them at risk for bone loss and fractures needs to be further studied," Dr. Sonal Singh told Reuters Health.

"We should be thinking about fractures in patients with asthma," he said. "The study did make me think about the link between asthma and bone loss as I see my patients."

Singh, from Johns Hopkins University School of Medicine in Baltimore, Maryland, was not involved in the current research but has studied broken bones in people taking steroids for chronic obstructive lung disease.

The Centers for Disease Control and Prevention estimates that 25 million Americans - or one in 12 - have asthma. The US Surgeon General in 2012 predicted that by 2020 half of Americans over age 50 could have weak bones.

For the new study, researchers led by Dr. Jae-Woo Jung of Seoul National University Medical Research Center analyzed the health records of 7,034 patients seen at their hospital.

They found average bone density was lower in the lumbar spine in the 216 people who tested positive for airway hyperresponsiveness.

The lumbar spine is the region between the ribs and the pelvis.

In addition, about 45 percent of those patients had osteopenia, or lower than normal bone density, and six percent had osteoporosis. That compared to a 30 percent rate of osteopenia and a four percent rate of osteoporosis among people without airway hyperresponsiveness, according to findings published in the Annals of Allergy, Asthma & Immunology.

The study also found a lower bone density in the lumbar spines of people who reported having been diagnosed with asthma than in people without asthma. But Singh said it was hard to know whether that was meaningful, because the researchers didn't measure asthma objectively.

Previous studies have found lower vitamin D levels among patients with asthma and related symptoms, the authors write.

They did not respond to a request for comment but speculate in the study that vitamin D deficiency might factor into bone loss among people with asthma and airway hyperresponsiveness.

The current study did not measure participants' vitamin D levels, so it can't say anything about the vitamin's link to asthma and bone loss.

Fractures are a known side effect of the systemic steroids used to treat asthma, Jung and colleagues write. Several studies have also tied inhaled steroids to decreased bone density, they note.

Steroids can decrease bone formation by stopping calcium from being absorbed. The drugs can also interfere with production of sex hormones, causing muscle weakness and raising the risk of falls and related fractures, according to the National Institutes of Health.

The NIH also says that people with asthma may avoid calcium-rich milk and other dairy products as well as weight-bearing exercise - key ingredients for bone health.

In the new study, the researchers excluded patients who had used systemic steroid medications. But the study did not consider participants' use of inhaled steroids or other drugs for control of asthma and related symptoms.

Singh said the study prompted him to want to examine asthma and bone loss in research considering ethnicity, physical activity, vitamin D levels and use of inhaled steroids. — Reuter

source: gmanetwork.com

Stress in pregnancy linked to children's asthma risk

NEW YORK - Stress during pregnancy brought on by events like divorce, job loss or death of a loved one appears to be linked to an increased risk of asthma and eczema among children.

These findings, Dr. Petra Arck told Reuters Health in an email, could "allow clinicians to evaluate future asthma risk in unborn children using a simple life event assessment questionnaire."

Arck, of University Medical Center Hamburg-Eppendorf in Germany, and her colleagues note that although there are strong genetic components to asthma and related conditions, these alone do not help explain the unprecedented increase in such diseases in recent years.

Over the same period as that increase, they add, stress levels have been on the rise. But there hasn't been much evidence to connect stress in pregnancy to asthma and eczema.

To investigate further, the researchers examined data from 1,587 children and their mothers who took part in an Australian pregnancy study. The original purpose of the study was to determine the effects of intensive fetal monitoring on pregnancy outcomes.

Mothers-to-be were asked about recent stressful life events halfway through their pregnancy and again toward the end of pregnancy. Their children were evaluated for asthma, eczema and other allergy-related conditions at age six and 14.

Complete data were available for 994 children and their mothers.

The researchers calculated that the likelihood of having asthma or eczema as a teenager was substantially higher among children of mothers who experienced stressful life events during the second half of their pregnancies.

Specifically, kids were about twice as likely to have asthma as 14-year-olds if their mothers had been through a single stressful life event, once other factors known to influence asthma were taken into account. Risks were similar when mothers had experienced multiple life stressors.

When the researchers looked closer, they found that pattern only held among children whose mothers did not have asthma themselves.

There was no link between stressful events in pregnancy and a child's chance of having asthma or eczema at age six, according to findings published in the Journal of Allergy and Clinical Immunology.

The authors note that they did not have information on how mothers-to-be coped with stressful life events or the types of social support they had available.

And they point out that factors other than stress in pregnancy might have been responsible for the increased risk of disease in certain children.

One researcher not involved in the study said it was well designed and addressed an important topic, but urged caution when interpreting the findings.

Alet H. Wijga, from the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, echoed the warning that stress, itself, may not have been what caused kids' asthma and eczema.

"Life events like money problems, job loss and residential move associated with separation or divorce during pregnancy may well have lasting impact on the socio-economic position of the mother and her child and may, for example, be associated with unfavorable indoor and outdoor exposures throughout the child's life course up to adolescence," Wijga told Reuters Health in an email.

"I do think the study provides evidence for an association between prenatal adverse life events and the risk for allergic disease in childhood," Wijga said. The challenge in the future will be to sort out the possible effects of stress during pregnancy from a child's environment growing up, the researcher added. — Reuters

source: gmanetwork.com