IMPACT OF INHALED GLUCOCORTICOIDS ON SERUM CORTISOL LEVELS AND PHYSICAL PERFORMANCE IN CHILDREN

Abstract

Objective: This study aims to assess the impact of inhaled corticosteroids (ICS) - salmeterol fluticasone powder on serum cortisol levels and physical performance in children with bronchial asthma. Methods: A cohort of 28 children with mild to moderate asthma, previously untreated with ICS, was recruited from the outpatient department. They were divided into a treatment group (15 children) and a control group (13 children). The control group received montelukast alone, while the treatment group was administered inhaled salmeterol fluticasone powder in addition. Serum cortisol levels for both groups were measured before treatment and after 3 months. Furthermore, the study monitored 17, 17, 15, 18, and 17 children with asthma who had been regularly using salmeterol fluticasone powder for durations of 6 months, 9 months, 1 year, 1.5 years, 2 years, and over 2 years, respectively, assessing both serum cortisol levels and evaluating physical performance through standardized fitness tests. Results: Initial findings showed that serum cortisol levels in the treatment group were 206.45±75.78 nmol/L before treatment and 209.88±80.35 nmol/L after 3 months, while in the control group, the levels were 210.72±80.10 nmol/L before treatment and 209.54±98.93 nmol/L after 3 months. No significant statistical difference was observed in serum cortisol levels between the treatment and control groups before and after treatment (all P>0.05). Similarly, children who regularly inhaled salmeterol fluticasone powder for extended periods showed no significant change in serum cortisol levels at any time point (all P> 0.05). Assessment of physical performance did not reveal any adverse effects on the physical capabilities or fitness levels of children in the treatment group, indicating that the recommended dose of salmeterol fluticasone powder does not impair, and may potentially support, physical performance in children with asthma. Conclusion: The administration of the recommended dose of salmeterol fluticasone powder in children with asthma does not significantly affect serum cortisol levels and does not impair physical performance, suggesting its safety for long-term use in managing asthma symptoms while maintaining physical activity and fitness levels.