Effects of Short-term Inhaled Budesonide and Beclomethasone Dipropionate on Serum Osteocalcin in Premenopausal Women

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Abstract
Serum osteocalcin, a marker of bone osteoblast function, has been shown to be sensitive to even low doses of oral glucocorticoids. The effect of 1 wk of inhaled glucocorticoid therapy with budesonide (200 micrograms/puff), beclomethasone dipropionate (250 micrograms/puff), and placebo at two puffs b.i.d. and four puffs b.i.d. on 0900 serum osteocalcin were compared in a double-blind randomized fashion. A two-way repeated-measures analysis of variance showed no main effect of drug or dosage but a significant drug-dose interaction (p = 0.023). Post hoc investigation of this interaction demonstrated that the serum osteocalcin level while taking four puffs b.i.d. (2,000 micrograms) of beclomethasone dipropionate was significantly lower than that of placebo or budesonide at four puffs b.i.d. (1,600 micrograms). These results suggest that at lower doses no acute measurable effect of inhaled glucocorticoids on serum osteocalcin can be appreciated but that at higher doses inhaled beclomethasone dipropionate has a depressant effect on bone osteoblast function.