الفهرس 
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Abstract
Asthma is the most common chronic disease of childhood. It is a worldwide problem that affect approximately 300 million people worldwide.
Inhaled corticosteroids (ICS) are recommended as first line anti-inflammatory therapy for treatment of asthma in children for more than 20 years. During this time a substantial number of studies have been performed for evaluation of safety and efficacy of this therapy.
The present work is a case control study conducted to assess the effect of long term inhalation with corticosteroids (ICS) for asthma control in children on fat distribution and bone density.
We studied 120 children of both sexes ,with ages ranging from 5 to 10 years. They were classified into 3 groups . group I, included 40 children of both sexes (20 males and 20 females) with moderate asthma and given ICS in moderate doses (200-400 Mg budesonide or equipotent)For at least 3 years.
group II included 40 children of both sexes (22 males and 18 females) with ages ranging from 5 to 10 years suffering from severe asthma and treated with high doses (<400Mg budesonide or equivalent) for 3 years and more.
group III, comprised 40 healthy children (24 males and 16 females), not receiving any treatment or complaining of any chronic illness of same age and sex to serve as controls.
group I and II were chosen from allergy outpatient clinic of pediatric hospital Cairo university in the period from September 2016 till April 2017, while group III was chosen from patients relatives or from surgical unit of pediatric hospital.
All patients and controls were subjected to the following: good history and thorough clinical examination, chest x-ray, peak expiratory flow rate to measure FEVI, anthropometric measurements (height, weight, biceps and triceps skin folds, waist and hip circumference) and bone mineral density (BMD) measured by DEXA.
Our results revealed a statistically significant difference in anthropometric measurements in the three studied groups.
Weight and body mass index (BMI) were significantly higher in severely asthmatic (group II) than moderately asthmatic (group I) and control (group III). This may be attributed to the use of high doses of ICS for long periods.
Regarding height there was a statistically significant decrease in patients of group III (control) than the other two groups. This show that ICS had no effect on height in this age group even if used in high doses.
No statistically significant difference was found between the studied groups regarding the waist circumference (P>0.05), while the mean hip circumference in the severely asthmatic (group II) was statistically significant higher than that in moderate asthma (group I) and control (group III).
The biceps and triceps skin fold thickness as well as their sum were statistically significant higher in group I and II (moderate & severe asthma) than group III (control group).
It was also recorded in our study that there was no statistically significant difference between the 3 studied groups regarding BMD studied by DEXA.
A statistically significant positive correlation was found between BMD (gm/cm2) of lumber vertebrae (L1-L4) and duration of illness.
Conclusion:
We can conclude that long term use of ICS in high doses for long periods for asthma control in severely asthmatic Egyptian children can affect fat distribution leading to increase in fat deposition in upper arm (sum of biceps and triceps skin fold thickness), and hip circumference as well as more weight gain, but it has no effect on bone mineral density (BMD).