title: Bone mineral density in children exposed to chronic glucocorticoid therapy.
abstract: The objective of this study was to determine the impact of glucocorticoid exposure on lumbar spine bone mineral density (BMD) in children while concurrently measuring their calcium intake, serum 25-OH vitamin D levels, and physical activity. Forty-three patients (4-18 years) with renal glomerular diseases, dermatomyositis, inflammatory bowel disease, juvenile rheumatoid arthritis, post-solid organ transplant, and Duchenne muscular dystrophy were studied. All received at least 5 mg per day of prednisone for more than 6 months. The mean BMD z score was 0 +/- 0.2 (range, -3.8 to +3.3) with 2 patients (5%) having z scores less than -2. The mean daily calcium intake was 1147 +/- 145 g, with 1 patient having hypovitaminosis D (<15 ng/mL). The mean physical activity level was 7.8 +/- 0.8 h/wk. The small reductions in BMD observed in our population suggest that screening is likely not warranted in all children with chronic glucocorticoid exposure.
authors: Division of Pediatric Gastroenterology, Hepatology and Nutrition, Children's Memorial Hospital, Chicago, Illinois 60614, USA. vcohran@childrensmemorial.org
authors: Valeria C
authors: VC
authors: Cohran
authors: Mark
authors: M
authors: Griffiths
authors: James E
authors: JE
authors: Heubi
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000188:drug therapy; D015519:Bone Density; D002136:Calcium, Dietary / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003882:Dermatomyositis / Q000188:drug therapy; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy; D007674:Kidney Diseases / Q000188:drug therapy; D007678:Kidney Glomerulus; D008159:Lumbar Vertebrae; D008297:Male; D009043:Motor Activity; D020388:Muscular Dystrophy, Duchenne / Q000188:drug therapy; D010024:Osteoporosis / Q000139:chemically induced; D011241:Prednisone / Q000009:adverse effects*; D019737:Transplants; D014807:Vitamin D / Q000097:blood
chemical_list: D002136:Calcium, Dietary; D005938:Glucocorticoids; D014807:Vitamin D; D011241:Prednisone