J Rheum Dis.  2018 Oct;25(4):248-254. 10.4078/jrd.2018.25.4.248.

Prevalence of Lower Bone Mineral Density and Its Associated Factors in Korean Children and Adolescents with Juvenile Idiopathic Arthritis

• Shin J
• Kang MJ
• Kim KN

• KMID: 2429711
• DOI: http://doi.org/10.4078/jrd.2018.25.4.248

Abstract

OBJECTIVE
This study examined the prevalence of low-bone mineral density (BMD) and its associated factors in Korean children and adolescents with juvenile idiopathic arthritis (JIA).
METHODS
Thirty-nine patients with JIA were included in this cross-sectional study. The patients were examined for their bone age (BA) and bone mineral density (BMD). The BMD was measured using dual-energy X-ray absorptiometry on the lumbar spine. Each BMD value was converted to a Z-score by comparing the reference values of the healthy control group in terms of the age and sex of each patient, which was measured using the same device. A Z-score of less than −2.0 was defined as a low BMD. Laboratory tests were performed to detect the serum calcium, phosphorus, alkaline phosphatase, and 25-hydroxyvitamin D levels.
RESULTS
The mean age at the time of the examination was 12.2±3.6 years, and the study comprised a total of 39 patients (16 males, 23 females). Patients with systemic JIA had a lower BMD, which was calculated based on the CA, BA, and HA, than those with non-systemic JIA (P=0.020, P=0.049, and P=0.024, respectively); the corticosteroid user group also showed a lower BMD, which had been calculated based on the CA, BA, and HA, than the corticosteroid non-user group (p=0.002, p=0.022, and p=0.188, respectively).
CONCLUSION
This study suggests that JIA patients have a lower BMD than control subjects. Therefore, treatment, and education are warranted while treating patients with JIA, particularly those requiring oral corticosteroids or those with systemic JIA and appropriate laboratory tests.

Keyword

Juvenile idiopathic arthritis; Bone mineral density

MeSH Terms

Absorptiometry, Photon
Adolescent*
Adrenal Cortex Hormones
Alkaline Phosphatase
Arthritis, Juvenile*
Bone Density*
Calcium
Child*
Cross-Sectional Studies
Education
Humans
Male
Miners
Phosphorus
Prevalence*
Reference Values
Spine
Adrenal Cortex Hormones
Alkaline Phosphatase
Calcium
Phosphorus

Figure

• 

  Figure 1. Comparison of BMD between JIA and control group. CA: chronological age, BA: bone age, HA: height age, BMD: bone mineral density, JIA: juvenile idiopathic arthritis. *p-value＜0.05.

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