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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
[Bone mineral density in patients with juvenile idiopathic arthritis]
Gordana Sušić1, Nada Pilipović, Roksanda Stojanović
1Institute of Rheumatology, Belgrade, Serbia.
Insights
Children with juvenile idiopathic arthritis (JIA) have lower bone mineral density (BMD) compared to healthy peers. Factors like systemic onset, polyarthritis, and glucocorticoid treatment negatively impact bone health in JIA patients.
Area of Science:
- Pediatric Rheumatology
- Bone Metabolism
- Inflammatory Diseases
Context:
- Juvenile idiopathic arthritis (JIA) is a chronic childhood inflammatory disease.
- JIA can lead to significant complications, including bone metabolism disturbances and osteoporosis.
- Understanding these complications is crucial for managing long-term health in affected children.
Purpose:
- To evaluate bone mineral density (BMD) in children diagnosed with JIA.
- To identify specific factors contributing to bone mineral disturbances in JIA patients.
- To provide insights for targeted interventions and improved patient care.
Summary:
- This study assessed BMD in 75 children with JIA using dual-energy X-ray absorptiometry (DEXA), comparing them to 73 healthy controls.
- JIA patients exhibited significantly lower BMD (Z score: -1.02 ± 1.6) versus controls (Z score: -0.09 ± 1.4).
- Factors such as systemic onset, polyarticular disease, prolonged glucocorticoid use, and disease severity negatively correlated with BMD.
Impact:
- The findings highlight a significant decrease in BMD among children with JIA.
- Identifies key disease characteristics and treatment-related factors (e.g., systemic onset, glucocorticoid therapy) that exacerbate bone metabolism issues.
- Emphasizes the need for monitoring and managing bone health in pediatric patients with JIA.
Introduction:
It is well known that juvenile idiopathic arthritis (JIA) as a chronic inflammatory disease with onset during the childhood, beside other complication, can lead to bone metabolism disturbance and osteoporosis.
Objective:
To assess bone mineral density (BMD) in children with JIA and to identify factors playing role in bone mineral disturbance.
Methods:
Seventy-five patients (26 male and 49 female) average disease duration 7.2 (2.4-16.8) years, and 73 age matched healthy control subjects (29 male and 44 female) participated in the study. Mean age of the groups was about 14.5 years. BMD was determined by dual x-ray absorptiometry (DEXA) of the lumbar spine (L2-L4). For further analysis we used the absolute value of BMD, expressed as g/cm2, Z score expressed as SD (relative value as standard deviation decline of normal BMD values of referent Italian population with identical age and gender), bone mineral content (BMC) as g/cm, and corrected BMD-BMDv as g/cm3.
Results:
Z score in the group of patients was significantly lower (-1.02 +/- 1.6) in comparison to the control group (-0.09 +/- 1.4; p<0.001). BMD, BMDv and BMC were also statistically lower in patients with JIA. The lowest Z score was found in patients with systemic onset (-2.63 SD). Z score showed a statistically significant positive correlation with arthritis course (polyarticular course had lower Z score), body mass index and standard deviation score for height and weight. Statistically significant negative correlation was detected in regard to Z score and glucocorticoid (GC) treatment duration, GC cumulative dose, number of joints with limited range of motion, radiological stage and functional class.
Conclusion:
The results showed a decreased BMD in patients with JIA in comparison to the control group. Systemic onset, polyarthritis, longer treatment with GC and higher cumulative dosage, as well as higher damage level (functional status and radiological stage) are factors playing negative role in bone metabolism in children with JIA.
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