The threshold of bone mineral density for vertebral fractures in female patients with primary hyperparathyroidism

Background and objective: Primary hyperparathyroidism (pHPT) is one of the causal diseases that induce secondary osteoporosis. Although patients with pHPT have reduced bone mineral density (BMD) especially at the cortical bone, there have been controversies about risk of fracture. Moreover, no reports have been available about the threshold of BMD for fractures in pHPT patients. Methods: BMD values were measured by dual-energy x-ray absorptiometry at lumbar spine, femoral neck and distal one third of radius. Various indices were compared in 116 female pHPT patients and 716 control subjects. Moreover, we analyzed relationship between the cut-off values of BMD and the prevalence of vertebral fractures in pHPT and control subjects. Results: The prevalence of subjects with vertebral fractures was lower in pHPT patients, compared with that of control subjects. Age and body height were significantly higher and lower in pHPT women with vertebral fractures, respectively. Lumbar spine BMD was significantly lower in pHPT women with vertebral fractures, presumably due to their increased age. There were no differences in femoral neck and radius BMD or in bone metabolic indices between pHPT women with and without vertebral fractures. On the other hand, age-matched BMD was not significantly different between both groups at any measured site. Cut-off values of BMD at lumbar spine and femoral neck were lower in postmenopausal pHPT patients, compared with those of the postmenopausal control group. Moreover, cut-off values of BMD at radius was much lower in postmenopausal pHPT patients, compared with those of the postmenopausal control group (pHPT vs control (g/cm2): 0.670 vs 0.706 at lumbar spine; 0.549 vs 0.570 at femoral; 0.394 vs 0.474 at radius). Sensitivity and specificity of vertebral fractures was lower in pHPT patients, compared with those in control group. Conclusions: The present cross-sectional study demonstrated that thresholds of BMD for vertebral fractures were lower especially at radial bone in female patients with pHPT, compared with those in the control group.

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Brisk Walking Reduces Calcaneal Bone Loss in Post-Menopausal Women

Clinical Science ◽

10.1042/cs0920075 ◽

1997 ◽

Vol 92 (1) ◽

pp. 75-80 ◽

Cited By ~ 44

Author(s):

Katherine Brooke-Wavell ◽

Peter R. M. Jones ◽

Adrianne E. Hardman

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Bone Loss ◽

Femoral Neck ◽

Bone Mineral ◽

Brisk Walking ◽

Mineral Density ◽

Control Subjects ◽

Menopausal Women ◽

Post Menopausal

1. This study examined the influence of brisk walking on skeletal status in post-menopausal women. 2. Subjects were 84 healthy women aged 60–70 years who were previously sedentary and at least 5 years post-menopausal. Subjects were randomly assigned to walking (n = 43) and control (n = 41) groups. Walkers followed a 12-month, largely unsupervised programme of brisk walking. The bone mineral density of the lumbar spine, femoral neck and calcaneus and broadband ultrasonic attention of the calcaneus were measured at baseline and after 12 months. 3. Forty control subjects and 38 walkers completed the study. Walkers built up to 20.4 ± 3.8 min/day (mean ± SD) of brisk walking. Body mass increased in control subjects relative to walkers [mean change (SE) ± 0.9 (0.3) and −0.1 (0.3) kg respectively; P = 0.04]. Predicted maximum oxygen uptake increased in walkers by 2.1 (0.9) ml min−1 kg−1 (P = 0.02). Bone mineral density in the lumbar spine and calcaneus fell in control subjects [–0.005 (0.004) and −0.010 (0.004) g/cm2, respectively] but not in walkers [+0.006 (0.004) and +0.001 (0.004) g/cm2]. The difference in response between groups was significant in the calcaneus (P = 0.04) but not in the lumbar spine (P = 0.08). Mean femoral neck bone mineral density did not change significantly in either group, although changes in walkers were related to the amount of walking completed (r = 0.51, P = 0.001). The change in broadband ultrasonic attenuation of the calcaneus differed between groups [control subjects, −3.7 (0.8); walkers, −0.7 (0.8) dB/MHz; P = 0.01]. 4. Walking decreased bone loss in the calcaneus and possibly in the lumbar spine. It also improved functional capacity and enabled walkers to avoid the increase in body mass seen in control subjects.

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Changes in Bone Mineral Density Following Conventional Oral Phosphonate Treatment of Hypophosphatemic Osteomalacia: a case-control study

10.21203/rs.2.12284/v1 ◽

2019 ◽

Author(s):

Yue Guo ◽

Xian-Ping Wu ◽

Ying-Hui Zhou ◽

Chen-Yi Tang ◽

Min Wang ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Conventional Treatment ◽

Control Group ◽

Mineral Density ◽

Total Hip ◽

Hypophosphatemic Osteomalacia ◽

Phosphate Supplementation

Abstract Background: There are limited clinical studies aimed at solving the problem of the efficiency of conventional treatment with oral phosphate and calcitriol in adults with hypophosphatemic osteomalacia (HO). In addition, there still had no good non-hazardous markers to evaluate the severity of bone loss of osteomalacia before and after treatment. Therefore, the purpose of this study was to assess the efficacy of conventional treatment with a self-blended phosphate supplementation and calcitriol on patients with HO and whether bone mineral density (BMD) can helpful for monitoring the efficacy. Methods: 21 HO patients and 105 healthy controls were enrolled. HO patients with calcium and calcitriol were divided into three phosphate treatment groups: Patients in group A (n=3) received continuous phosphate supplementation, patients in group B (n=5) received intermittent phosphate supplementation and patients in group C (n=3) received no phosphate supplementation. 11 of 21 HO patients were recalled for detection of BMD of the lumbar spine (L1–L4), femoral neck, and total left hip three years after the treatment. Results: The average initial serum phosphorus level of the patient group was approximately 50% lower than that of the control group. Lower BMD was significantly observed in the HO group than the control group at the lumbar spine and total hip. Continuous treatment with the phosphate supplement could increase BMD in the lumbar spine and total hip by 33.4–52.3% and the femoral neck increased by 43.2–79.3% compared with baseline, and the effect appears to be continued once treatment is discontinued. Conclusions: These findings suggest that conventional therapy can improve bone mineral defects in patients with HO, especially in the femoral neck. Detection of BMD in HO patients is a good tool to assess the extent of bone defects and the therapeutic effect.

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Bone Mineral Density, TBS, and Body Composition Indexes in Ukrainian Men with Parkinson’s Disease

Parkinson s Disease ◽

10.1155/2019/9394514 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Vladyslav Povoroznyuk ◽

Maryna Bystrytska ◽

Nataliia Grygorieva ◽

Iryna Karaban ◽

Nina Karasevich

Keyword(s):

Bone Mineral Density ◽

Body Composition ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Fat Mass ◽

Lean Mass ◽

Control Group ◽

Mineral Density ◽

Total Body

Introduction. Current research studies demonstrate the changes of bone mineral density (BMD) in subjects with Parkinson’s disease (PD); however, data about bone quality and body composition (BC) indexes are insufficient. The aim of the study was to assess the parameters of BMD, ВС, and trabecular bone score (TBS) in PD males. Materials and Methods. We performed a cross-sectional case-control research design and examined 76 males aged 50–77 years old, who were divided into two groups: first group including men without PD n=38 and the second group including subjects with PD n=38. Disease duration was at least 5 years; all PD participants were at levodopa therapy. BMD of lumbar spine, femoral neck, total femur, radius, and total body and TBS Ll−L4 were measured using the DXA method. Whole-body DXA measures were also used for the study of total, lean, and fat masses, skeletal muscle index (SMI), appendicular lean mass index (ALMI), and fat mass index (FMI). Results. Our study showed an increased incidence of osteoporosis and significantly lower total body BMD (respectively, 1.20 ± 0.13 and 1.26 ± 0.10 g/cm2, p=0.05), but not lumbar spine and femoral neck BMDs, and higher TBS value in PD men comparing to the control group (respectively, 1.33 ± 0.12 and 1.22 ± 0.18 un., p=0.005). Also, we established significantly decreased lower extremities BMD indexes, but not upper extremities, spine, and trunk BMDs in PD males. The femoral neck, proximal femur, and lower extremities BMD indexes in PD men were reliably lower at the side of predominance of clinical symptoms. Parameters of appendicular lean mass and ALMI in PD males were reliably higher, but fat mass values and FMI were lower compared to the control group in the absence of significant differences in lean mass values and SMI in weight-matched control. Conclusion. Due to low BMD values, changes in BC are present in PD males, and appropriate screening and preventive strategies should be instigated to maintain bone health in PD subjects.

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Association between estrogen receptor alpha gene polymorphisms and bone mineral density in Polish female patients with Graves' disease.

Acta Biochimica Polonica ◽

10.18388/abp.2011_2292 ◽

2011 ◽

Vol 58 (1) ◽

Cited By ~ 1

Author(s):

Magdalena Ignaszak-Szczepaniak ◽

Wanda Horst-Sikorska ◽

Joanna Dytfeld ◽

Ewelina Gowin ◽

Ryszard Słomski ◽

...

Keyword(s):

Bone Mineral Density ◽

Estrogen Receptor ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Premenopausal Women ◽

Graves Disease ◽

Mineral Density ◽

Female Patients ◽

Esr1 Gene

Graves' (GD) hyperthyroidism leads to reduced bone mineral density (BMD) accompanied by accelerated bone turnover. Ample studies have identified association between estrogen receptor (ESR1) gene polymorphism and decreased BMD and osteoporosis. In contrast, number of publications that link ESR1, BMD and Graves' disease is limited. The purpose of this study was to identify the association between ESR1 polymorphisms and BMD in premenopausal women with GD and to determine whether ESR1 polymorphic variants can predispose to GD. The study included 75 women aged 23-46 years with GD and 163 healthy controls. BMD was measured at lumbar spine and femoral neck. We investigated two SNPs in the ESR1 gene and analyzed genetic variants in the form of haplotypes reconstructed by statistical method. Three out of four possible haplotypes of the PvuII and XbaI restriction fragment length polymorphisms were found in GD patients: px (55.3 %), PX (33.3 %) and Px (11.4 %). Women homozygous for xx of XbaI and for pp of PvuII had the lowest BMD at lumbar spine. Moreover, the px haplotype predisposed to reduced lumbar BMD. No associations were observed for femoral neck BMD. No statistically significant relationship were found between ESR1 polymorphisms or their haplotypes and GD. These results indicate that the PvuII and the XbaI polymorphisms of ESR1 gene are associated with bone mineral density in premenopausal women with GD and may help to estimate the risk of bone loss particularly at lumbar spine. However, none of the ESR1 gene alleles predict the risk of GD in Polish female patients.

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Effect of different types of exercise on bone mineral density in postmenopausal women: A systematic review and meta-analysis

Osteologie/Osteology ◽

10.1055/a-1180-0594 ◽

2020 ◽

Vol 29 (03) ◽

pp. 179-193

Author(s):

Mahdieh Shojaa ◽

Simon von Stengel ◽

Daniel Schoene ◽

Matthias Kohl ◽

Wolfgang Kemmler

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Resistance Training ◽

Femoral Neck ◽

Postmenopausal Women ◽

Bone Mineral ◽

Weight Bearing ◽

Control Group ◽

Mineral Density ◽

Meta Analyses

AbstractPostmenopausal women face a high risk of bone loss. Exercise has a beneficial effect to prevent bone deterioration in elderly women. This study was conducted to investigate the effect of different types of exercise on bone mineral density at the lumbar spine and femoral neck in postmenopausal women.This review followed the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and was registered in advance in the International prospective register of systematic reviews (PROSPERO) (ID: CRD42018095097). Literature searches with no language restriction were conducted through PubMed, Scopus, Web of Science, Cochrane, Science Direct, Eric, ProQuest, and Primo up to March 1 2019 using related MeSH terms and key words. Controlled trials with ≥ 6 months intervention duration among postmenopausal women that comprised at least one exercise and one control group were included in this study. Meta-analyses were performed using random-effects models and effect sizes calculated using the standardised mean difference (SMD). Seven categories of exercise were classified and used in sub-group analyses. P-values < 0.05 were considered statistically significant.Seventy-five studies were included, assessing the bone mineral density of 5300 (range of mean age: 50–79) postmenopausal women who performed exercise or control protocols. Interventions ranged from six to 30 months and the most common exercise frequency was three sessions per week. The majority of studies employed multicomponent exercise interventions. Results of the meta-analyses showed a significant effect (SMD = 0.37, 95%-CI: 0.25–0.50) for lumbar spine and femoral neck (SMD = 0.33, 0.23–0.43) (all P < 0.0001).Sub-group analysis revealed large heterogeneity and no significant differences in exercise categories at the lumbar spine (P = 0.36) and femoral neck (P = 0.43). However, weight-bearing exercise + jumping + resistance training exhibited the largest effect (SMD = 0.71, 0.33–1.10) at the lumbar spine. Moreover, non-weight-bearing combined + resistance exercise revealed the largest effect (SMD = 0.68, 0.16–1.19) at the femoral neck. Contrary to our expectation, jumping alone indicated a greater decrease in bone mineral density compared to the control group at both the lumbar spine (−0.07, −0.46–0.32) and femoral neck (−0.12, −0.62–0.37).In conclusion, the current study provided a positive small effect of exercise on bone mineral density at the lumbar spine and femoral neck. Findings from sub-group analyses suggest larger benefits in multicomponent interventions that include weight-bearing and resistance training exercises compared to them as a single mode of exercise. Unequal numbers of studies were found for each category (e. g. jumping: two trials; dynamic resistance training: 15 trials), affecting the comparison between them. Therefore, findings should be interpreted with caution; they are not yet generalizable to specific types of exercise.

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Changes in bone mineral density after parathyroidectomy in patients with moderate to severe primary hyperparathyroidism

Journal of International Medical Research ◽

10.1177/0300060520964698 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052096469

Author(s):

Shuai Lu ◽

Maoqi Gong ◽

Yejun Zha ◽

Aimin Cui ◽

Chen Chen ◽

...

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Primary Hyperparathyroidism ◽

Bone Mineral ◽

Great Trochanter ◽

Severe Damage ◽

Mineral Density ◽

Total Hip ◽

Z Scores

Objective Primary hyperparathyroidism (PHPT) is relatively common in China and results in severe damage to the skeletal system. This study aimed to investigate changes in bone mineral density (BMD) over 2 years in patients with PHPT after parathyroidectomy. Methods This retrospective cohort study included patients with PHPT who underwent parathyroidectomy between January 2010 and December 2015. BMD and T-scores and Z-scores of the lumbar spine (L1, L2, L3, and L4) and total hip (femoral neck, great trochanter, and Ward’s triangle) at baseline and 2 years after surgery were measured by dual-energy X-ray absorptiometry. Results Thirty patients with moderate to severe PHPT (17 men and 13 women) aged 38.90±15.48 years were included. BMD, and T-score and Z-score values at the lumbar spine and total hip at 6 months, 1 year, and 2 years after parathyroidectomy were significantly improved compared with preoperative values. Improvement in BMD was largest at L4 (46.7%) and smallest at L1 (37.4%) in the lumbar spine 2 years after parathyroidectomy. For the total hip, the increase in BMD was largest at Ward’s triangle (42.6%) and smallest at the femoral neck (37.5%). Conclusions BMD of the lumbar spine and total hip is improved after parathyroidectomy in patients with PHPT.

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AB0910 SARCOPENIA AND BONE MINERAL DENSITY IN MEN WITH CORONARY HEART DISEASE

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.5401 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 1757.2-1757

Author(s):

T. Raskina ◽

I. Grigoreva ◽

J. Averkieva ◽

A. Kokov ◽

V. Masenko

Keyword(s):

Bone Mineral Density ◽

Coronary Heart Disease ◽

Heart Disease ◽

Lumbar Spine ◽

Femoral Neck ◽

Muscle Mass ◽

Bone Mineral ◽

Mineral Density ◽

Group 3 ◽

Group 2

Objectives:To examine bone mineral density (BMD) in men with coronary heart disease (CHD), depending on the state of the muscle mass, strength and function.Methods:79 men aged over 50 years with verified CHD were examined (mean age 63 (57; 66) years).The BMD and T-criterion (standart deviation, SD) of the femoral neck and lumbar spine (L1-L4) were evaluated using dual-energy x-ray absorptiometry (DXA) on the Lunar Prodigy Primo bone densitometer (USA). The following reference intervals were used: normal BMD values (T-criterion ≥-1), osteopenia (OPe) (T-criterion from -1 to -2.5), and osteoporosis (OP) (T-criterion <-2.5).To assess muscle mass, the total area (cm2) of the lumbar muscles of the axial section at the level of the 3rd lumbar vertebra (L3) was determined using multispiral computed tomography on a 64-slice computer tomograph “Somatom Sensation 64” (Siemens AG Medical Solution, Germany). The ratio of the obtained index of the area of skeletal muscle to the square of the patient’s growth index determined the “ skeletalmuscular index L3” (SMI). The media considered the threshold value to be 52.4 cm2/m2.Results:The femoral neck BMD in the examined patients was 0.96 (0.89; 1.03) g/cm2, which corresponds to -0.50 (-1.00; 0) SD according to the T-criterion, in the lumbar spine -1.23 (1.11; 1.32) g/cm2and 0.4 (-0.50; 1.20) SD according to the T-criterion.In accordance with the recommendations of the European working group on sarcopenia in Older people (EWGSOP, 2010, 2018), the patients were divided into 3 groups: 31 patients without sarcopenia (group 1), 21 patients with isolated muscle loss (presarcopenia) (group 2) and 27 patients with sarcopenia (group 3).BMD in the femoral neck in the group of patients without sarcopenia was 0.96 (0.72; 1.26) g/cm2, which corresponds to -0.50 (-0.8; 0.2) SD according to the T-criterion, in the lumbar spine – 1.19 (1.10; 1.275) g/cm2and 0.1 (-0.6; 0.8) SD according to the T-criterion. BMD in the femoral neck in the group of patients with presarcopenia (group 2) – 0.995 (0.94; 1.04) g/cm2and -0.3 (-0.70; 0) SD according to the T-criterion, in the lumbar spine – 1.32 (1.24; 1.40) g/cm2and 1.20 (0.50; 1.90) SD according to the T-criterion. In patients with established sarcopenia (group 3), the following indicators of BMD and T-criterion were recorded: 0.95 (0.845; 0.98) g/cm2and -0.60 (-1.40; -0.40) SD and 1.23 (0.085; 1.31) g/cm2and 0.4 (-0.8; 1.1) SD in the femoral neck and lumbar spine, respectively.A comparative analysis of the results of the DXA found that patients with sarcopenia had a significant decrease in the BMD and T-criterion in the femoral neck compared to patients with presarcopenia (p=0.039 and p=0.040, respectively). There were no differences between the groups of patients without sarcopenia and with sarcopenia and presarcopenia (p>0.05).It was found that patients with sarcopenia had significantly lower BMD and T-criterion in the lumbar spine compared to patients with presarcopenia (p=0.017 and p=0.0165, respectively). The values of the BMD and T-criterion in the groups of patients without sarcopenia and with presarcopenia and sarcopenia in the lumbar spine were comparable (p>0.05).Conclusion:The presence of sarcopenia is associated with loss of BMD in the femoral neck and in the lumbar spine. The results obtained confirm the high probability of common pathogenetic links between OP and sarcopenia.Disclosure of Interests:None declared

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Bone mineral density predictors in long-standing type 1 and type 2 diabetes mellitus

BMC Endocrine Disorders ◽

10.1186/s12902-021-00815-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stefana Catalina Bilha ◽

Letitia Leustean ◽

Cristina Preda ◽

Dumitru D. Branisteanu ◽

Laura Mihalache ◽

...

Keyword(s):

Diabetes Mellitus ◽

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Mineral Density ◽

Cross Sectional ◽

The Impact

Abstract Background Despite the increased fracture risk, bone mineral density (BMD) is variable in type 1 (T1D) and type 2 (T2D) diabetes mellitus. We aimed at comparing independent BMD predictors in T1D, T2D and control subjects, respectively. Methods Cross-sectional case-control study enrolling 30 T1D, 39 T2D and 69 age, sex and body mass index (BMI) – matched controls that underwent clinical examination, dual-energy X-ray absorptiometry (BMD at the lumbar spine and femoral neck) and serum determination of HbA1c and parameters of calcium and phosphate metabolism. Results T2D patients had similar BMD compared to T1D individuals (after adjusting for age, BMI and disease duration) and to matched controls, respectively. In multiple regression analysis, diabetes duration – but not HbA1c- negatively predicted femoral neck BMD in T1D (β= -0.39, p = 0.014), while BMI was a positive predictor for lumbar spine (β = 0.46, p = 0.006) and femoral neck BMD (β = 0.44, p = 0.007) in T2D, besides gender influence. Age negatively predicted BMD in controls, but not in patients with diabetes. Conclusions Long-standing diabetes and female gender particularly increase the risk for low bone mass in T1D. An increased body weight partially hinders BMD loss in T2D. The impact of age appears to be surpassed by that of other bone regulating factors in both T1D and T2D patients.

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Lack of Association between Pulse Steroid Therapy and Bone Mineral Density in Patients with Multiple Sclerosis

Multiple Sclerosis International ◽

10.1155/2016/5794910 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Serap Zengin Karahan ◽

Cavit Boz ◽

Sevgi Kilic ◽

Nuray Can Usta ◽

Mehmet Ozmenoglu ◽

...

Keyword(s):

Multiple Sclerosis ◽

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Steroid Therapy ◽

Negative Relationship ◽

High Dose ◽

Mineral Density ◽

Factors Affecting

Multiple sclerosis (MS) has been associated with reduced bone mineral density (BMD). The purpose of this study was to determine the possible factors affecting BMD in patients with MS. We included consecutive 155 patients with MS and 90 age- and sex-matched control subjects. Patients with MS exhibited significantly lowerT-scores andZ-scores in the femoral neck and trochanter compared to the controls. Ninety-four (61%) patients had reduced bone mass in either the lumbar spine or the femoral neck; of these, 64 (41.3%) had osteopenia and 30 (19.4%) had osteoporosis. The main factors affecting BMD were disability, duration of MS, and smoking. There was a negative relationship between femoral BMD and EDSS and disease duration. No association with lumbar BMD was determined. There were no correlations between BMD at any anatomic region and cumulative corticosteroid dose. BMD is significantly lower in patients with MS than in healthy controls. Reduced BMD in MS is mainly associated with disability and duration of the disease. Short courses of high dose steroid therapy did not result in an obvious negative impact on BMD in the lumbar spine and femoral neck in patients with MS.

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Estimation of Central Osteopenia in Children With Chronic Polyarthritis Treated With Glucocorticoids

PEDIATRICS ◽

10.1542/peds.91.6.1127 ◽

1993 ◽

Vol 91 (6) ◽

pp. 1127-1130

Author(s):

Antero Kotaniemi ◽

Anneli Savolainen ◽

Hannu Kautiainen ◽

Heikki Kröger

Keyword(s):

Bone Mineral Density ◽

Lumbar Spine ◽

Femoral Neck ◽

Bone Mineral ◽

Bone Size ◽

Mineral Density ◽

Volumetric Density ◽

Chronic Polyarthritis ◽

The Mean ◽

Bone Volumetric Density

Study objective. To investigate the degree and determinants of osteopenia in juvenile chronic polyarthritis. Design. Retrospective case-control study of central bone mineral density. Setting. Rheumatism Foundation Hospital and Kuopio University Hospital, Finland. Subjects. A sample of 43 girls aged 7 to 19 with juvenile chronic polyarthritis treated with systemic glucocorticoids and a control sample of 44 healthy girls matched for age. Main outcome measures. Bone mineral density and bone size (width) measured by dual-energy x-ray absorptiometry and bone volumetric density calculated as an approximation of true bone density at both the lumbar spine and femoral neck. Results. The girls with juvenile chronic arthritis had reduced bone mineral density, bone size, and bone volumetric density at both the lumbar spine and femoral neck (statistically significant findings, P = .022 for the bone size of the femoral neck and P < .001 for the other parameters). At the spine, the mean bone mineral density was 80%, the mean bone size 89%, and the mean bone volumetric density 89% of the values in the control group. At the femoral neck, the values were 78%, 93%, and 83%, respectively. The groups were matched for age, but the girls with arthritis were smaller and lighter. In the juvenile arthritis group, the femoral bone mineral density and bone volumetric density and the spinal bone width correlated negatively with the mean glucocorticoid dose. Conclusion. Axial bone mineral density is clearly reduced in severe juvenile polyarthritis and is mediated by both decreased bone volumetric density and diminished growth.

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