A Two-Year Prospective Controlled Study of Bone Mass and Bone Turnover in Children With Early Juvenile Idiopathic Arthritis

被引:86
作者
Lien, Gunhild [1 ]
Selvaag, Anne M.
Flato, Berit
Haugen, Margaretha [2 ]
Vinje, Odd
Sorskaar, Dag
Dale, Knut
Egeland, Thore
Forre, Oystein
机构
[1] Univ Hosp, Rikshosp, Dept Rheumatol, N-0027 Oslo, Norway
[2] Norwegian Inst Publ Hlth, Oslo, Norway
来源
ARTHRITIS AND RHEUMATISM | 2005年 / 52卷 / 03期
关键词
D O I
10.1002/art.20963
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. To explore early changes and predictors of bone mass in children with juvenile idiopathic arthritis (JIA) in order to identify patients who will develop bone mass reductions. Methods. We conducted a prospective cohort study of 108 children with early JIA (ages 6-18 years; mean disease duration 19.3 months) who were individually matched with 108 healthy children for age, sex, race, and county of residence. Bone mass and changes in total body, spine, femur, and forearm bone mineral density and bone mineral content (BMC), body composition, growth, and biochemical parameters of bone turnover were examined at baseline and at followup a mean of 24 months later. Low bone mass was defined as a Z score > 1 SD below the reference population. Results. Of the 200 children evaluated at followup, the 100 healthy children had greater gains in total body BMC (P = 0.035), distal radius BMC (P < 0.001), and total body lean mass (P < 0.001) than did the 100 JIA patients. Low or very low total body BMC was observed in 24% of the patients and 12% of the healthy children. Bone formation, bone resorption, and weight-bearing activities were reduced in the patients compared with the healthy children. Multiple regression analysis showed that in patients with RA, serum bone-specific alkaline phosphatase, serum C-telopeptide of type I collagen, and weight-bearing activities were independent predictors of changes in total body BMC. Total body BMC was lower in patients with polyarticular onset than in those with oligoarticular disease onset. Conclusion. Patients with JIA have moderate reductions in bone mass gains, bone turnover., and total body lean mass early in the disease course.
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页码:833 / 840
页数:8
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