A two-year prospective controlled study of bone mass and bone turnover in children with early juvenile idiopathic arthritis
Article first published online: 4 MAR 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 52, Issue 3, pages 833–840, March 2005
How to Cite
Lien, G., Selvaag, A. M., Flatø, B., Haugen, M., Vinje, O., Sørskaar, D., Dale, K., Egeland, T. and Førre, Ø. (2005), A two-year prospective controlled study of bone mass and bone turnover in children with early juvenile idiopathic arthritis. Arthritis & Rheumatism, 52: 833–840. doi: 10.1002/art.20963
- Issue published online: 4 MAR 2005
- Article first published online: 4 MAR 2005
- Manuscript Accepted: 7 DEC 2004
- Manuscript Received: 7 AUG 2004
- Research Council of Norway (Isbergs Legacy)
- Oslo Women's Public Health Association
- Jan A. Pahles Research Legacy
- Norwegian Rheumatism Association
- Grethe Harbitz Legacy
- Solveig Amalie Husbys Memorial Foundation
- Olga Imerslund Foundation
- Marie and Else Mustad Legacy
To explore early changes and predictors of bone mass in children with juvenile idiopathic arthritis (JIA) in order to identify patients who will develop bone mass reductions.
We conducted a prospective cohort study of 108 children with early JIA (ages 6–18 years; mean disease duration 19.3 months) who were individually matched with 108 healthy children for age, sex, race, and county of residence. Bone mass and changes in total body, spine, femur, and forearm bone mineral density and bone mineral content (BMC), body composition, growth, and biochemical parameters of bone turnover were examined at baseline and at followup a mean of 24 months later. Low bone mass was defined as a Z score >1 SD below the reference population.
Of the 200 children evaluated at followup, the 100 healthy children had greater gains in total body BMC (P = 0.035), distal radius BMC (P < 0.001), and total body lean mass (P < 0.001) than did the 100 JIA patients. Low or very low total body BMC was observed in 24% of the patients and 12% of the healthy children. Bone formation, bone resorption, and weight-bearing activities were reduced in the patients compared with the healthy children. Multiple regression analysis showed that in patients with JIA, serum bone-specific alkaline phosphatase, serum C-telopeptide of type I collagen, and weight-bearing activities were independent predictors of changes in total body BMC. Total body BMC was lower in patients with polyarticular onset than in those with oligoarticular disease onset.
Patients with JIA have moderate reductions in bone mass gains, bone turnover, and total body lean mass early in the disease course.