Bone mineral density in children with systemic lupus erythematosus and juvenile rheumatoid arthritis

BACKGROUND: Although there is increasing interest in bone metabolism in patients with rheumatic disorders, few data exist on bone mineral density (BMD) in children with rheumatic disorders or on the association of BMD with disease-related variables. We determined BMD in Iranian children with systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis (JRA) to evaluate the relationship between disease-related variables and BMD. PATIENTS AND METHODS: Twenty patients (13 girls and 7 boys) with SLE (n=15) and JRA (n=5) with a mean age of 13.10±3.29 years (range, 6–17 years), attending a pediatric rheumatology clinic and 20 healthy controls (matched for age and sex with each patient) were enrolled in a cross-sectional study between 2001 and 2003. BMD (g/cm(2)) of the femoral neck (BMD-F) and lumbar vertebrae (BMD-L) were measured by dual energy X-ray absorptiometry (DEXA). The correlation between BMD and cumulative dose of steroids, daily dose of steroid, disease duration, disease activity, height, weight, and age was investigated. RESULTS: BMD in the patients (BMD-F=0.72±0.15, BMD-L=0.70±0.19) was significantly lower than controls (BMD-F=0.95±0.17, BMD-L=0.98±0.20, P<0.001). The severity of decreased BMD was more prominent in lumbar vertebrae than the femoral neck (P= 0.04). None of the variables were consistently related to a decrease in BMD. CONCLUSION: BMD was significantly lower in patients compared with controls. It was more prominent in lumbar vertebrae (trabecular bone). Although cumulative dose of steroids and disease duration appeared to have some influence on BMD, none were independently correlated with BMD.