Frequency Of Osteopenia In Adolescents With Early-Onset Juvenile Idiopathic Arthritis - A Long-Term Outcome Study Of One Hundred Five Patients
ARTHRITIS AND RHEUMATISM(2003)
摘要
Objective. To determine the frequency of low bone mineral content (BMC) and low bone mineral density (BMD) as long-term complications in adolescents with early-onset juvenile idiopathic arthritis (JIA), and to identify disease variables, patient characteristics, and biochemical bone markers related to low bone mass.Methods. One hundred five (87%) of 121 adolescent patients with early-onset JIA (ages 13-19 years, 80 girls and 25 boys, mean age at onset of JIA 2.8 years), from a cohort first admitted to the hospital between 1980 and 1985, were assessed after a mean disease duration of 14.2 years. BMC and BMD of the total body, the lumbar spine at L2-L4, and the femoral neck were measured by dual-energy x-ray absorptiometry. Age-and sex-specific reference values from a pooled, healthy reference population were used to calculate Z scores. Low bone mass was defined as a Z score less than -1 SD.Results. Among the 103 adolescent JIA patients who underwent total-body imaging, 41% had low total-body BMC and 34% had low total-body BMD. Compared with adolescent JIA patients who had normal total-body BMC, those with low BMC had lower mean weight (P<0.001), height (P<0.001), lean mass (P<0.001), and remission rates (P=0.016), had longer duration of active disease (P=0.013), had higher numbers of active and mobility-restricted joints (P<0.001 and P=0.001, respectively), had more disability (P=0.011), had higher frequencies of joint erosions (P<0.001), and had higher erythrocyte sedimentation rates (P=0.033). In multiple linear regression analyses of total-body BMC, 88% of the variance was explained by the duration of active disease, the number of joints with restricted mobility, the bone area, urinary deoxypyridinoline values, age, weight, and height.Conclusion. Forty-one percent of the adolescents with early-onset JIA had low bone mass >11 years after disease onset. The development of low total-body BMC was related to the duration of active disease, disease severity, measures of bone resorption, weight, and height.
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