Characteristics of bone mineral density and its biochemical markers in children with bronchial asthma
https://doi.org/10.53529/2500-1175-2025-4-24-39
Abstract
Patients with asthma are at increased risk of developing osteopenia due to decreased bone mineral density (BMD). Particular attention is given to the role of vitamin D, whose deficiency is associated with the management of symptoms and bone health.
Study Objective. To study BMD and its biochemical markers, with an emphasis on vitamin D status and intake in children with asthma in the Moscow region.
Materials and Methods. Anamnestic, questionnaire, and laboratory methods were used, including assessment of nutritional impact, grade D, biochemical markers of bone metabolism, and molecular genetic analysis. Mineral support was obtained using X-ray densitometry. Data were statistically processed using SPSS Statistics 26 (IBM) using parametric and nonparametric methods at a significance level of p <0.05.
Results. The included study included 100 children with asthma, 15 % of whom had AD, and showed decreased BMD of varying severity. Most patients had low vitamin D levels, which were gradually adjusted and required oral cholecalciferol. High-dose inhaled glucocorticosteroids were associated with a more frequent decrease in BMD, while higher BMD values were recorded in children with moderate physical activity. The level of 25(OH)D was significantly lower in patients with asthma carrying the GG genotype of the VDR (FokI) gene polymorphism compared to those with the AA and AG genotypes. No relevant medical studies on bone health were identified.
Conclusion. This study confirms a significant decrease in BMD in children with asthma compared to those in medical settings and reveals significant changes in biochemical markers of bone metabolism. Low vitamin D levels and limited physical activity in this group of patients necessitate comprehensive treatment and correction of metabolic changes to prevent long-term complications, including osteoporosis. A multidisciplinary approach that combines stress management, nutritional status improvement, and physical activity is essential to BMD and reduce the risk of bone disease in adulthood.
Supporting agencies: Budget funds within the framework of scientific research commissioned by the Ministry of Health of the Moscow Region (“Patterns and mechanisms of bone mineral density reduction in healthy children and in various inflammation models (microbial-inflammatory, allergic, metabolic, and autoimmune). Improvement of prevention and therapy in real clinical practice.” Reg. No. R&D: 122013100175-3.)
About the Authors
E. S. Nikonova
State Budgetary Healthcare Institution of the Moscow Region “Research and Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”
Россия
Россия
Ekaterina Sergeevna Nikonova — allergist-immunologist, head of the department of allergology and immunology for children, research fellow at the department of hereditary and metabolic diseases at the Research Clinical Institute of Childhood
141009, Moscow Region, Mytishchi Urban District, Mytishchi, Kominterna St., bld. 24A, str. 1
Yu. S. Smolkin
State Budgetary Healthcare Institution of the Moscow Region “Research and Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”;
Academy of Postgraduate Education of the Federal State Budgetary Institution “Federal Research and Clinical Center for Specialized Medical Care and Medical Technologies of the Federal Medical-Biological Agency”
Россия
Россия
Yuri Solomonovich Smolkin — Dr. Sci., Professor of the Department of Clinical Immunology and Allergology at the Postgraduate Education Academy of the FSBI Federal Scientific Clinical Center FMBA of Russia, chief Researcher of the scientific and organizational Department of the State Budgetary Healthcare Institution of the Moscow Region “Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”
141009, Moscow Region, Mytishchi Urban District, Mytishchi, Kominterna St., bld. 24A, str. 1
125371, Moscow, Volokolamskoye Highway, 91
E. K. Zhekaite
State Budgetary Healthcare Institution of the Moscow Region “Research and Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”;
Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics named after Academician N.P. Bochkov”
Россия
Россия
Elena Kyastutisovna Zhekaite — Cand. Sci., leading research fellow of the Cystic Fibrosis Department at the Medical Genetics Research Center named after Academician N.P. Bochkov, leading research fellow of the Department of Hereditary and Metabolic Diseases, pediatrician at the Cystic Fibrosis Department of the State Budgetary Healthcare Institution of the Moscow Region “Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”
141009, Moscow Region, Mytishchi Urban District, Mytishchi, Kominterna St., bld. 24A, str. 1
115522, Moscow, Moskvorechye St., 1
A. S. Sorokin
State Budgetary Healthcare Institution of the Moscow Region “Research and Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”;
Plekhanov Russian University of Economics
Россия
Россия
Alexander Sergeevich Sorokin — Cand. Sci., leading research fellow at the Department of Hereditary and Metabolic Diseases of the State Budgetary Healthcare Institution of the Moscow Region “Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region,” Associate Professor of the Department of Mathematical Methods in Economics at the Plekhanov Russian University of Economics
141009, Moscow Region, Mytishchi Urban District, Mytishchi, Kominterna St., bld. 24A, str. 1
115054, Russian Federation, Moscow, Stremyanny Lane, 36
V. V. Shadrina
State Budgetary Healthcare Institution of the Moscow Region “Research and Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”;
Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics named after Academician N.P. Bochkov”
Россия
Россия
Vera Vladislavovna Shadrina — Cand. Sci., head of the Department of Hereditary and Metabolic Diseases at the State Budgetary Healthcare Institution “Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”; leading research fellow of the scientific-clinical Cystic Fibrosis Department at the FSBI Medical Genetics Research Center named after Acad. N.P. Bochkov
141009, Moscow Region, Mytishchi Urban District, Mytishchi, Kominterna St., bld. 24A, str. 1
115522, Moscow, Moskvorechye St., 1
E. I. Kondratyeva
State Budgetary Healthcare Institution of the Moscow Region “Research and Clinical Institute of Childhood of the Ministry of Health of the Moscow Region”;
Federal State Budgetary Scientific Institution “Research Centre for Medical Genetics named after Academician N.P. Bochkov”
Россия
Россия
Elena Ivanovna Kondratyeva — Dr. Sci., Professor, head of the scientific-clinical Cystic Fibrosis Department, head of the Department of Genetics of Respiratory Diseases at the Institute of Higher and Additional Professional Education of the Medical Genetics Research Center named after Academician N.P. Bochkov; Deputy Director of the State Budgetary Healthcare Institution of the Moscow Region “Research Clinical Institute of Childhood of the Ministry of Health of the Moscow Region,”
141009, Moscow Region, Mytishchi Urban District, Mytishchi, Kominterna St., bld. 24A, str. 1
115522, Moscow, Moskvorechye St., 1
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Review
For citations:
Nikonova E.S., Smolkin Yu.S., Zhekaite E.K., Sorokin A.S., Shadrina V.V., Kondratyeva E.I. Characteristics of bone mineral density and its biochemical markers in children with bronchial asthma. Allergology and Immunology in Paediatrics. 2025;(4):24-39. (In Russ.) https://doi.org/10.53529/2500-1175-2025-4-24-39
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