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Titolo:
PREDICTORS OF TOTAL-BODY BONE-MINERAL DENSITY IN NON-CORTICOSTEROID-TREATED PREPUBERTAL CHILDREN WITH JUVENILE RHEUMATOID-ARTHRITIS
Autore:
HENDERSON CJ; CAWKWELL GD; SPECKER BL; SIERRA RI; WILMOTT RW; CAMPAIGNE BN; LOVELL DJ;
Indirizzi:
CHILDRENS HOSP,MED CTR,DIV RHEUMATOL,3333 BURNET AVE,PAVIL 2-129 CINCINNATI OH 45229 CHILDRENS HOSP,MED CTR,DIV RHEUMATOL CINCINNATI OH 45229 UNIV S FLORIDA,ALL CHILDRENS HOSP ST PETERSBURG FL 33701 AMER COLL SPORTS MED INDIANAPOLIS IN 00000
Titolo Testata:
Arthritis and rheumatism
fascicolo: 11, volume: 40, anno: 1997,
pagine: 1967 - 1975
SICI:
0004-3591(1997)40:11<1967:POTBDI>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
PHYSICAL-ACTIVITY; AGE; ACCELEROMETER; OSTEOPOROSIS; METHOTREXATE; METABOLISM; WOMEN; MASS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
47
Recensione:
Indirizzi per estratti:
Citazione:
C.J. Henderson et al., "PREDICTORS OF TOTAL-BODY BONE-MINERAL DENSITY IN NON-CORTICOSTEROID-TREATED PREPUBERTAL CHILDREN WITH JUVENILE RHEUMATOID-ARTHRITIS", Arthritis and rheumatism, 40(11), 1997, pp. 1967-1975

Abstract

Objective, To determine the extent of significant osteopenia in prepubertal patients with juvenile rheumatoid arthritis (JRA) not treated with corticosteroids and to identify variables that are highly related to bone mineralization in this population. Methods. In a cross-sectional study, 48 JRA patients and 25 healthy control subjects ages 4.6-11.0 years were evaluated. Total body bone mineral density (TB BMD) was determined by Hologic dual energy x-ray absorptiometry. All patients were prepubertal (Tanner stage I or II) and had never taken corticosteroids. For comparison, JRA patients were divided into ''low'' TB BMD (Z score less than or equal to -1) or ''normal'' TB BMD (Z score >-1). Results. The overall mean +/- SD TB BMD scores did not differ between the JRA subjects (0.75 +/- 0.06 gm/cm(2)) and controls (0.73 +/- 0.07 gm/cm(2); P > 0.30), However, 29.2% of the JRA patients had low TB BMD, whereas only 16% would be expected to have low TB BMD based on the standard normal distribution (goodness of fit chi(2) = 4.84, P = 0.01), The mean Z score for the JRA patients with low TB BMD was -1.43, and for those with normal TB BMD, it was 0.32, The JRA subjects with low TB BMD were significantly younger, had more active articular disease, greater physical function limitation, higher erythrocyte sedimentation rate, higher joint count severity score, lower body mass index, lower lean body mass, less participation in organized sports, and more proteinand vitamin D in their diet compared with JRA patients with normal TBBMD (all P < 0.05), Using logistic regression, a model including age at JRA onset, Juvenile Arthritis Functional Assessment Report (JAFAR) score, triceps skinfold percentiles, percentage US recommended daily allowance for dietary magnesium intake, and serum 1,25-dihydroxyvitaminD levels was able to accurately segregate 79.6% of the JRA subjects into either the low or normal TB BMD groups (chi(2) = 20.5, P = 0.001). Conclusion. This study demonstrated that in a mildly to moderately ill prepubertal JRA population that had never been exposed to corticosteroids, almost 30% had significantly low TB BMD, The patients with low TB BMD had more active and severe articular disease and greater physical function limitation, Disease-related parameters in JRA appear to exert a negative effect on bone mineralization even in prepubertal children, which can be demonstrated despite the exclusion of corticosteroid-treated patients.

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Documento generato il 03/12/20 alle ore 21:40:28