Effects of nutritional supplementation on bone mineral status of children with rheumatic diseases receiving corticosteroid therapy.
OBJECTIVE
Because children with rheumatic disease receiving longterm corticosteroids are at high risk for developing osteoporosis, we attempted to determine whether nutritional supplementation would improve bone status in this group of children.


METHODS
In a crossover design study, 10 corticosteroid treated children with rheumatic disease and osteoporosis received calcium and vitamin D supplementation for 6 months to determine their effect on bone density. They were then studied for 6 months without added nutrition supplements. The mean age was 13.1 years with a mean duration of disease of 4.2 years. Six patients had juvenile rheumatoid arthritis, 2 had systemic lupus erythematosus and 2 had mixed connective tissue disease. These children obtained a minimum of 1 g of calcium and 400 IU of vitamin D daily from diet and added supplements. Dual photon absorptiometry, laboratory and dietary data were obtained at baseline, 6 months, and one year.


RESULTS
Spinal bone density significantly improved with supplementation. Osteocalcin values remained low throughout the study.


CONCLUSIONS
Our results suggest some children with rheumatic disease receiving corticosteroids would benefit from calcium and vitamin D supplementation.
Warady
B D
BD
Childrens Rehabilitation Unit, University of Kansas Medical Center, Kansas City 66160-7330.
Lindsley
C B
CB
Robinson
F G
FG
Lukert
B P
BP
D015055:1-Carboxyglutamic Acid / Q000097:blood; D015502:Absorptiometry, Photon; D000284:Administration, Oral; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D000469:Alkaline Phosphatase / Q000097:blood; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control*; D002118:Calcium / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008903:Minerals / Q000032:analysis*; D008947:Mixed Connective Tissue Disease / Q000188:drug therapy* / Q000378:metabolism; D011884:Radius / Q000737:chemistry* / Q000473:pathology; D013131:Spine / Q000737:chemistry* / Q000473:pathology; D014807:Vitamin D / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D008903:Minerals; D014807:Vitamin D; D015055:1-Carboxyglutamic Acid; D000469:Alkaline Phosphatase; D002118:Calcium