Bone mineral density in patients with juvenile idiopathic arthritis

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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P013 Serum osteoprotegerin and RANKL in patients with Juvenile Idiopathic Arthritis and their correlation with bone mineral density

Rheumatology ◽

10.1093/rheumatology/keab722.005 ◽

2021 ◽

Vol 60 (Supplement_5) ◽

Author(s):

Radwa Helmy Shalaby ◽

Elham Mohamed Kassem ◽

Nagat Mohamed El-Gazzar ◽

Sahar Ahmed Fathy Hammoudah ◽

Amal Mohamed El-Barbary

Keyword(s):

Bone Mineral Density ◽

Juvenile Idiopathic Arthritis ◽

Lumbar Spine ◽

Bone Mineral ◽

Disease Duration ◽

Serum Levels ◽

Z Score ◽

Low Bone Mass ◽

Mineral Density ◽

Serum Rankl

Abstract Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic arthropathy of childhood and is associated with low bone mass, and may hasten the onset of osteoporosis later in life1. Bone loss occurs because of an imbalance between osteoclasts-activating factors like receptor activator of nuclear factor-κB ligand (RANKL) and its inhibitor osteoprotegerin (OPG) 2. Dual energy X-ray absorptiometry (DXA) is the preferred method for measuring bone mineral density (BMD) in children and to identify and follow individuals at risk for fracture 3. The objective is the Evaluation of serum levels of osteoprotegerin and RANKL and their correlation with BMD in JIA patients. Methods Forty JIA patients (according to the revised classification criteria of ILAR) and 40 healthy children individually matched for age, sex and race were included in this study. Children excluded from the study were those with primary and secondary causes of osteoporosis (such as chronic illness). All patients were assessed clinically by: age, sex, body mass index, type of JIA, disease duration and disease activity (by Juvenile Arthritis Disease Activity Score; JADAS 10). The functional disability was assessed by the Childhood Health Assessment Questionnaire (CHAQ). Blood samples were collected from JIA patients and healthy controls to determine serum levels of OPG and RANKL by ELISA. DXA scans were done using GE Healthcare Lunar DPX, Madison, Wisconsin. Bone mineral density of the L1-L4 lumbar spine and total body less head (TBLH) was evaluated in g/cm2 and expressed as Z score for age, sex according to the reference data given for this equipment. Results The study included 40 patients (25 females) with a mean age of 11.14 years and median disease duration of 2.5 years. As regard JIA type, 45% of patients were oligoarticular, 32.5% were polyarticular, and 22.5% were systemic JIA. Median JADAS 10 was 13.95. Patients (especially polyarticular JIA) had significantly higher serum RANKL levels and lower serum OPG and OPG/RANKL ratio when compared with controls (with p-value <0.001, 0.032 and <0.001 respectively). A diagnosis of low BMD (BMD Z-score ≤ -2) was given in 25% of patients (15% polyarticular and 10% systemic) by DXA of lumbar spine, and 20% (10% polyarticular and 10% systemic) by DXA of TBLH. On the other hand, no patient was given a diagnosis of osteoporosis (BMD Z-score ≤ -2 and a significant fracture history). Low BMD at lumbar spine and TBLH was negatively correlated with serum RANKL while positively correlated with OPG/RANKL ratio. Moreover, low BMD at lumbar spine was positively correlated with serum OPG level Conclusion High RANKL and low OPG levels appear to be associated with low bone mass in JIA patients. Patients with JIA (especially polyarticular and systemic subtype) are at increased risk of low bone mineral mass. Disclosure of Interests None declared

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309 Effects of dietary supplying icariin on the bone metabolism and the laying performance in caged laying hens

Journal of Animal Science ◽

10.1093/jas/skz258.020 ◽

2019 ◽

Vol 97 (Supplement_3) ◽

pp. 11-11

Author(s):

Jie Huang ◽

Lei Zhang ◽

Zhongxin Zhou

Keyword(s):

Bone Mineral Density ◽

Bone Metabolism ◽

Bone Mineral ◽

Laying Hens ◽

Egg Quality ◽

Control Group ◽

Tartrate Resistant Acid Phosphatase ◽

Mineral Density ◽

Laying Performance ◽

Serum Biochemical

Abstract Icariin, a flavonol glycoside, is one of major active ingredients of the traditional Chinese medicine Herba epimedii. Icariin has been reported to successfully treat the osteoporosis of the rat. However, effects of icariin on the osteoporosis in caged laying hens are still unkown. This study present the effects of dietary icariin supplementation on the laying performance, the egg quality and the bone metabolism in caged laying hens. A total of 216 Lohmann pink-shell laying hens of 54-week-old from a commercial farm in the Hubei province of China were randomly assigned to 3 treatment groups with 6 replications per group and 12 birds per replication. The control group was fed a corn-soybean meal basal diet, and the experimental groups were fed basal diets supplemented with 500 and 2000 mg/kg icariin for 90 d. Layer performance responses, egg quality parameters, the bone mineral density and serum biochemical indicators were measured at the end of the experiment. Results showed that feed/egg ratio decreased as the supplied icariin level increased. The laying rate and the average egg weight were increased compared to the control group. However, no significant effect was observed on the egg quality. The bone mineral density of the tibia was measured by the dual-energy X-ray absorptiometry, indicating that icariin can increase the bone mineral density. Serum biochemical analysis showed that icariin decreased the level of alkaline phosphatase, tartrate-resistant acid phosphatase, osteocalcin and calcitonin. Our observations provided evidences that dietary supplementation of icariin increased the bone mineral density and improved the laying performance, and icariin can be used for the prevention of the osteoporosis in caged laying hens.

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Комплексная оценка минерально-костных нарушений у женщин с оксалатной нефропатией в постменопаузе

Dalʹnevostočnyj medicinskij žurnal ◽

10.35177/1994-5191-2020-2-5-10 ◽

2020 ◽

pp. 5-10

Keyword(s):

Bone Mineral Density ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Bone Metabolism ◽

Bone Mineral ◽

Calcium Metabolism ◽

Control Group ◽

Mineral Density ◽

High Level ◽

Oxalate Nephropathy

A study was made of phosphorus-calcium metabolism, markers of bone metabolism, bone mineral density in 142 women in the early postmenopausal period, the patients with oxalate nephropathy at stage 2 of chronic kidney disease. It is proved that patients have signs of secondary hyperparathyroidism (hypocalcemia, hypercalciuria, increased parathyroid hormone) and a deﬁciency of 25 (OH) D3. Violation of bone metabolism is conﬁrmed by a high level of β-Cross Laps and a decrease in bone mineral density. The probability of a 10-year risk of developing osteoporetic fractures in patients using the FRAX calculator is two times higher than in the control group. The conclusion was made that patients with oxalate nephropathy have a high risk of developing osteoporosis already in the early stages of chronic kidney disease.

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KOSTNAYa MASSA I KOSTNYY METABOLIZM U DETEY S YuVENIL'NYM IDIOPATIChESKIM ARTRITOM

Osteoporosis and Bone Diseases ◽

10.14341/osteo2011319-23 ◽

2011 ◽

Vol 14 (3) ◽

pp. 19-23

Author(s):

M. M. KOSTIK ◽

M. M. MNUSKINA ◽

I N MAKAROVA ◽

D. A. KUZ'MINA ◽

L. A. ShchEPLYaGINA ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Metabolism ◽

Bone Mineral ◽

Bone Mineralization ◽

Disease Onset ◽

Negative Influence ◽

Chronological Age ◽

Reference Database ◽

Z Score ◽

Mineral Density

This study describes bone metabolism in children withjuvenile idiopathic arthritis (JIA), association between disturbances of bone metabolism with inflammatory activity, juvenile arthritis disease course and therapy in 198 children. Low bone mineral density (BMD) for chronological age was detected by dual-energy X-ray absorptiometry of lumbar spine L1-L4 (densitometer Hologic QDR 4500C, with pediatric reference database) than Z -score < -2 SD in 36 children (18,2%), in 18 girls (15,5%) and in 18 boys (21,9%). Girls with low BMD received glucocorticoids (GCS) in 66,7 % cases, and girls with normal BMD received it in 26,5% cases (р=0,002). Girls with low BMD had lower height, weight, earlier age of disease onset and higher clinical and laboratory parameters of arthritis activity. Girls with low BMD had higher osteocalcin and tendency to decreased parathyroid hormone levels compared to the girls with normal BMD. Children who received GCS had specific stereotypic changes: boys had significantly lower bone mineral density and total Ca and girls had significantly lower bone mineral content and BMD (g/cm2 and Z-score), total Са, non-organic phosphate and total alkaline phosphatase activity. Patients with systemic arthritis had significantly lower mineralization and bone metabolism turnover compared to children with oligoarticular and polyarticular JIA subtypes. Independent predictors of skeletal mineralization were age onset f JIA (р<0,0001), duration of the disease (p<0,0001), hemoglobin level (р=0,004), total calcium level (р=0,024), a2-globulins level (р=0,046). Independent predictors of low BMD were physician’s assessment VAS (р=0,024), C-reactive protein (р=0,04), inorganic phosphate (р=0,05). Systemic glucocorticoids exposure elevated the risk of low BMD for chronological age realization in JIA patients (OR=1,96, 95%CI=0,76-5,05). Enhanced risk of low BMD was in polyarthicular (OR=2,53, 95%CI=0,66-9,65) and systemic JIA (OR=3,16, 95%CI=0,73-13,76). Thus, parameters of inflammation have negative influence on bone metabolism velocity, linear growth and accordingly bone mineralization. Described factors explain heterogeneity of mineralization disorders.

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Bone mineral density in children with juvenile idiopathic arthritis after one year of treatment with etanercept

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh170811175s ◽

2018 ◽

Vol 146 (5-6) ◽

pp. 297-302

Author(s):

Gordana Susic ◽

Marija Atanaskovic ◽

Roksanda Stojanovic ◽

Goran Radunovic

Keyword(s):

Bone Mineral Density ◽

Juvenile Idiopathic Arthritis ◽

Rheumatoid Factor ◽

Bone Mineral ◽

Mineral Metabolism ◽

Z Score ◽

Mineral Density ◽

Bone Mineral Metabolism ◽

Systemic Jia ◽

One Year

Introduction/Objective. Juvenile idiopathic arthritis (JIA) is the most frequent chronic inflammatory, rheumatic disease of childhood, associated with disturbance of bone mineral metabolism, which develops gradually and progressively, and if untreated eventually leads to osteoporosis in adulthood. The aim of our study was to evaluate bone mineral density (BMD) in patients with JIA treated with etanercept over a period of one year. Methods. The prospective cohort study included 94 JIA patients (66 female, 28 male), their median age being 14.77 years. BMD was measured by dual-energy X-ray absorptiometry on the lumbar spine. Disease activity was assessed using the American College of Rheumatology Pedi 50 criteria. Results. After one year of treatment with etanercept, we found a statistically significant increment in all osteodensitometry variables (p < 0.001). Annual enhancement for the whole group was as follows: bone mineral content 15.8%, BMD 7.2%, BMDvol 4.2%. Z-score improved from -0.86 to -0.58 SD at the last visit, but decreased in rheumatoid factor-positive polyarthritis patients. Patients with systemic JIA had the lowest Z-score. Z-score correlated with functional disability level. BMD was lower in the group treated with glucocorticoids. Conclusion. Our results showed significant improvement of bone mineral density in children with JIA after one year of treatment with etanercept. Rheumatoid factor-positive and systemic JIA subtypes and treatment with glucocorticoids are the risk factors for impairing bone mineral metabolism.

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Tamoxifen and bone metabolism in postmenopausal low-risk breast cancer patients: a randomized study.

Journal of Clinical Oncology ◽

10.1200/jco.1994.12.5.992 ◽

1994 ◽

Vol 12 (5) ◽

pp. 992-997 ◽

Cited By ~ 146

Author(s):

B Kristensen ◽

B Ejlertsen ◽

P Dalgaard ◽

L Larsen ◽

S N Holmegaard ◽

...

Keyword(s):

Breast Cancer ◽

Bone Mineral Density ◽

Bone Metabolism ◽

Bone Mineral ◽

Mineral Content ◽

Serum Alkaline Phosphatase ◽

Low Risk ◽

Control Group ◽

Mineral Density ◽

Risk Breast Cancer

PURPOSE This trial was undertaken to evaluate the effect of adjuvant tamoxifen on bone metabolism in postmenopausal women undergoing surgery for low-risk breast cancer. PATIENTS AND METHODS In an open trial, 25 women were randomized to receive tamoxifen 30 mg/d for 2 years, and 25 women constituted the control group. Twenty women treated with tamoxifen and 23 women in the control group provided data for the analysis. Inclusion criteria were operation for low-risk breast cancer and cessation of menstruations for more than 1 year. Exclusion criteria were presence of metastases, disorders of bone metabolism, contraindications against tamoxifen, use of drugs with influence on bone metabolism, ailments that made bone mineral measurements impossible, and age greater than 65 years. Repeated measurements of bone mineral density and content at the lumbar spine and forearms, serum alkaline phosphatase, phosphate, and ionized calcium were performed in all patients. RESULTS Lumbar spine bone mineral density increased during the first year in women treated with tamoxifen and then stabilized, compared with decreased bone mineral density in the control group (P = .00074). Bone mineral content at the forearms remained almost stable in tamoxifen-treated women compared with a decrease in the control group (P = .024). Serum alkaline phosphatase, phosphate, and ionized calcium decreased in the tamoxifen group (P < .00001, P = .002, and P = .002, respectively). CONCLUSION Tamoxifen has estrogen-like effects on bone metabolism that result in an increase and stabilization of bone mineral density in the axial skeleton and a stabilization of bone mineral content in the appendicular skeleton.

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Assessment of Low Bone Mineral Density in Untreated Patients with Takayasu’s Arteritis

BioMed Research International ◽

10.1155/2021/6489631 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Lingfei Mo ◽

Jing Wang ◽

BoMiao Ju ◽

Yanhua Wang ◽

Jing Luo ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Loss ◽

Bone Metabolism ◽

Bone Mineral ◽

Takayasu’S Arteritis ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Control Group ◽

Mineral Density ◽

Low Bone Mineral Density

Chronic inflammation affects bone metabolism and accelerates bone loss. This study is aimed at analyzing the prevalence of low bone mineral density (LBMD) in patients with untreated Takayasu’s arteritis (TA) and risk factors. Forty untreated TA patients were enrolled, including 38 premenopausal women and 2 men before 50 years old. The control group included 60 age- and gender-matched healthy persons. Bone mineral density (BMD) of lumbar vertebrae and hip in patients with TA and the control group was measured by the dual-energy X-ray method. Serum 25OHD and β-CTX were also measured. The lumbar BMD of TA patients ( 0.89 ± 0.11 g/cm2) was significantly lower than that of the healthy control ( 0.97 ± 0.11 g/cm2). The prevalence of LBMD at the lumbar spine (17.50%) was significantly higher than that of the control group (3.33%). However, there was no significant difference at the hip. The 25OHD of TA patients was lower than that of healthy controls, while the level of β-CTX was higher. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) in patients with LBMD were higher than those in patients with normal BMD. According to univariate correlation analysis, there was a significant negative correlation between LDL-C and lumbar BMD. Binary logistic regression analysis showed that LDL-C was an important factor affecting the occurrence of LBMD in patients with TA ( OR = 25.269 , P = 0.02 ). Our result reveals bone loss in TA patients, which hints the relationship among inflammation, lipid metabolism, and bone metabolism.

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Effect of hypercortisolism on bone mineral density and bone metabolism: A potential protective effect of adrenocorticotropic hormone in patients with Cushing’s disease

Journal of International Medical Research ◽

10.1177/0300060517725660 ◽

2017 ◽

Vol 46 (1) ◽

pp. 492-503 ◽

Cited By ~ 9

Author(s):

Weihong Guo ◽

Fengao Li ◽

Chonggui Zhu ◽

Baoping Wang ◽

Kunling Wang ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Turnover ◽

Bone Metabolism ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Adrenocorticotropic Hormone ◽

Cushing's Disease ◽

Control Group ◽

Mineral Density ◽

Turnover Markers

Objective To investigate the effects of Cushing’s disease (CD) and adrenal-dependent Cushing’s syndrome (ACS) on bone mineral density (BMD) and bone metabolism. Methods Data were retrospectively collected for 55 patients with hypercortisolism (CD, n = 34; ACS n = 21) from January 1997 to June 2014. BMD was examined in all patients, and bone turnover markers were tested in some patients. Healthy controls (n = 18) were also recruited. Results The lumbar spine and femoral neck BMD were significantly lower in the ACS and CD groups than in the control group. Lumbar BMD was significantly lower in the ACS than CD group. The collagen breakdown product (CTX) concentrations were significantly higher while the osteocalcin and procollagen type I N-terminal propeptide (PINP) concentrations were significantly lower in the ACS and CD groups than in the control group. The PINP concentration was significantly lower while the CTX concentration was significantly higher in the ACS than CD group. In the CD group only, lumbar BMD and serum adrenocorticotropic hormone had a significant positive correlation. Conclusions Bone turnover markers indicated suppressed osteoblast and enhanced osteoclast activities. PINP and CTX changes might indicate bone mass deterioration. Adrenocorticotropic hormone might be protective for lumbar BMD in patients with CD.

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