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An Pediatr (Barc). 2017 Oct;87(4):218-225. doi: 10.1016/j.anpedi.2016.12.005. Epub 2017 Feb 23.

[Low bone mineral density in juvenile idiopathic arthritis: Prevalence and related factors].

[Article in Spanish]

Author information

1
Sección de Reumatología Pediátrica, UGC Pediatría, Hospital Regional Universitario de Málaga, Málaga, España; Departamento de Pediatría y Farmacología, Facultad de Medicina, Universidad de Málaga, Málaga, España. Electronic address: rociogalin@hotmail.com.
2
Sección de Reumatología Pediátrica, UGC Pediatría, Hospital Regional Universitario de Málaga, Málaga, España.
3
UGC Pediatría, Hospital Regional Universitario de Málaga, Málaga, España.
4
Sección de Reumatología Pediátrica, UGC Reumatología, Hospital Regional Universitario de Málaga, Málaga, España.
5
Sección de Gastroenterología y Nutrición Infantil, UGC Pediatría, Hospital Regional Universitario de Málaga, Málaga, España.

Abstract

INTRODUCTION:

Height adjustment is currently recommended for Z-score bone mineral density (BMD) assessed by dual energy X-ray absorptiometry. At present there are no studies that evaluate the prevalence of low BMD in paediatric patients with Juvenile Idiopathic Arthritis (JIA) in Spain following current recommendations.

OBJECTIVES:

To evaluate low BMD in JIA in paediatric patients with JIA in Spain following the latest recommendations, as well as to assess associated factors.

METHODS:

Observational cross-sectional study of Spanish JIA patients from 5 to 16 years-old, followed-up in a Paediatric Rheumatology Unit between July 2014 and July 2015. Anthropometric, clinical and treatment data were recorded. Dual energy X-ray absorptiometry, and bone metabolism parameters were collected, and a completed diet and exercise questionnaire was obtained.

RESULTS:

A total of 92 children participated. The population prevalence estimation of low BMD was less than 5% (95% CI). A significant positive correlation was found in the multiple linear regression analysis between the body mass index percentile (B: 0.021; P<.001) and lean mass index (B: 0.0002; P=.012), and BMD Z-score adjusted for height (Z-SAH). A significant negative correlation was found between fat mass index (B: -0.0001; P=.018) and serum type I collagen N-propeptide (B: -0,0006; P=.036) and Z-SAH.

CONCLUSIONS:

Low BMD prevalence in JIA patients in our population is low. An adequate nutritional status and the prevalence of lean over fat mass seem to promote the acquisition of bone mass. Those JIA patients with lower BMD could be subjected to an increase of bone turnover.

KEYWORDS:

Artritis idiopática juvenil; Baja densidad mineral ósea para la edad cronológica; Body composition; Bone mineral density; Composición corporal; Densidad mineral ósea; Estado nutricional; Juvenile idiopathic arthritis; Low bone mineral density for chronological age; Marcadores del metabolismo óseo; Nutritional status; bone turnover markers

PMID:
28237653
DOI:
10.1016/j.anpedi.2016.12.005
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