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Evaluation of bone mineral density and bone turnover markers in Egyptian children with juvenile rheumatoid arthritis
Archives of Medical Science, 11/03/09

Kandil ME et al. – JRA patients had lower BMD, higher frequency of low BMD (more prominent in the femoral neck) and higher OPG and RANKL levels compared with healthy children; suggesting that they may be at risk of developing premature osteoporosis and fractures later in life

• Case-control study
• 30 children having JRA and 25 healthy controls
• Study participants subjected to measurement of BMD of lumbar spines (L2-L4) and femoral neck using dual-energy-X-ray absorptiometry (DXA) with laboratory evaluation of bone turnover markers including serum receptor activator of nuclear factor kB-ligand (RANKL) and osteoprotegerin (OPG)

• Significantly lower femoral neck BMD than controls , and it was significantly lower in patients with corticosteroid therapy
• 8 patients (26.7%) and only 2 (8%) controls had low BMD at lumbar spine, while 13 patients (43.3%) and 2 (8%) controls had low BMD at femoral neck
• Patients showed significantly higher RANKL, OPG and deoxypyridinolin , while calcium, osteocalcin, bone-specific alkaline phosphatase and OPG/RANKL ratio significantly lower in them
• Patients with normal BMD significantly taller than patients with low BMD , while the number of active painful joints and swollen restricted mobility joints significantly higher in patients with low BMD , with no significant difference regarding disease duration and bone turnover markers

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