Effect of inhaled corticosteroids on forearm bone mineral density: The HUNT Study, Norway

Research output: Contribution to journalArticle


Purpose: To study the effect of inhaled corticosteroid (ICS) on bone mineral density (BMD) in an observational longitudinal study. Methods: In 1995-97, as part of the Nord-Trondelag Health Study, Norway, 10,941 subjects aged 20yr or more, either reporting asthma diagnosis/asthma-related symptoms or randomly selected, were interviewed, underwent spirometry and had their forearm BMD assessed. Among these, 4705 persons were invited to follow-up interview and bone densitometry in 2001; a total of 2848 subjects were eligible for analyses. Results: Use of corticosteroids for respiratory diseases was reported by 1262 subjects, and 528 subjects had used ICS at both baseline and follow-up. The yearly loss of adjusted forearm distal. BMD was higher in those reporting use of ICS at both baseline and follow-up compared to subjects without respiratory symptoms. In women the figures were 3.14 versus 2.26 mg/cm(2), whilst in men they were 3.76 versus 1.92 mg/cm(2) (both p < 0.01). No significant association was found between loss of BMD and neither daily dose nor duration of ICS use. Reduced lung function (forced expiratory flow in 1 s) was an independent risk factor for increased bone loss in both sexes. Conclusions: ICS users had greater bone loss at the forearm compared to ICS naive persons, but no significant dose-response effect between ICS and BMD was found. Residual confounding by disease severity cannot be ruled out, but even in case of an ICS causal effect, this should have minor clinical significance in most patients using tow to moderate doses of ICS. (c) 2007 Elsevier Ltd. ALL rights reserved.


  • Arnulf Langhammer
  • Siri Forsmo
  • Solfrid Lilleeng
  • Roar Johnsen
  • Leif Bjermer
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Respiratory Medicine and Allergy


  • COPD, asthma, corticosteroid osteoporosis, inhaled corticosteroids, bone densitometry (SXA)
Original languageEnglish
Pages (from-to)1744-1752
JournalRespiratory Medicine
Issue number8
Publication statusPublished - 2007
Publication categoryResearch