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Bone mineral density in children wth systemic lupus erythematosus and juvenile rheumatoid arthritis

Sara Kashef1, Forugh Saki, Zohreh Karamizadeh

  • 1Department of Pediatrics, Allergy Research Center, Division of Endocrinology, Shiraz University of Medical Sciences, Shiraz, Iran. kashefs@sums.ac.ir

Annals of Saudi Medicine
|December 7, 2007
PubMed

Insights

Pediatric patients with rheumatic disorders like systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis (JRA) exhibit significantly lower bone mineral density (BMD). This decrease was more pronounced in the lumbar spine, indicating a need for further investigation into bone health in these young patients.

Area of Science:

  • Pediatric Rheumatology
  • Bone Metabolism
  • Osteoporosis Research

Background:

  • Limited data exist on bone mineral density (BMD) in children with rheumatic disorders.
  • Bone metabolism is increasingly recognized as affected in adult rheumatic conditions.
  • This study addresses the knowledge gap regarding pediatric rheumatic diseases and bone health.

Purpose of the Study:

  • To determine BMD in Iranian children diagnosed with systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis (JRA).
  • To investigate the association between BMD and disease-related variables in pediatric rheumatic patients.

Main Methods:

  • A cross-sectional study was conducted between 2001 and 2003, enrolling 20 pediatric patients (SLE and JRA) and 20 age- and sex-matched healthy controls.
  • Bone mineral density (BMD) of the femoral neck (BMD-F) and lumbar vertebrae (BMD-L) was measured using dual-energy X-ray absorptiometry (DEXA).
  • Correlations were analyzed between BMD and factors including cumulative/daily steroid dose, disease duration, disease activity, height, weight, and age.

Main Results:

  • Patients with rheumatic disorders showed significantly lower BMD compared to healthy controls (P<0.001).
  • The reduction in BMD was more severe in the lumbar vertebrae (trabecular bone) than the femoral neck (P=0.04).
  • No single disease-related variable, including steroid dosage or disease activity, was consistently correlated with decreased BMD.

Conclusions:

  • Children with systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis (JRA) have significantly reduced bone mineral density (BMD).
  • The lumbar spine is more affected than the femoral neck in these pediatric patients.
  • While steroid use and disease characteristics may influence BMD, no independent correlation was found in this study.
Abstract

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