A recent study has found that inhaled steroids, commonly used to treat airway diseases like asthma and chronic obstructive pulmonary disease (COPD), can affect adrenal function.

The risk may be higher in patients using steroids for systemic treatment or those with multiple comorbidities, according to the study.

A team led by Professor Yoon Hee-young from the Department of Respiratory Medicine at Soonchunhyang University Seoul Hospital recently published a paper detailing the results of a retrospective analysis of sample cohort data from the National Health Insurance Service.

The research team investigated 66,631 patients diagnosed with asthma or COPD, examining their inhaled steroid use, average daily dose, and incidence of adrenal insufficiency (based on hospitalization records or two or more outpatient visits). They then compared the differences between users and non-users of inhaled steroids through statistical analysis.

The analysis revealed that the incidence of adrenal insufficiency in the group using inhaled steroids was 1.69 cases per 1,000 people, compared to 0.54 cases per 1,000 people in the non-user group, showing a significant difference.

The risk of adrenal insufficiency increased with higher doses of inhaled steroids, and even when the usage was divided into quartiles, all dosage groups showed a significantly higher risk of adrenal insufficiency.

Analysis of the correlation with age, gender, and smoking status showed that the association between inhaled steroid use and the risk of adrenal insufficiency remained regardless of these factors. In particular, a stronger association was found in patients using systemic steroids and those with high comorbidity scores.

Professor Yoon Hee-young emphasized, "This study, which confirmed that inhaled steroids can affect adrenal function when treating airway diseases, even though the absolute incidence of adrenal insufficiency was very low. Inhaled steroids should be used carefully with appropriate doses, and it is necessary to establish a safe treatment strategy through thorough monitoring of patients using systemic steroids or those with multiple comorbidities."