title: Bone health in adult men and women with a history of juvenile idiopathic arthritis.
abstract: OBJECTIVE
  Our aim was to determine areal bone mineral density (BMD(a)) and disease-related factors linked with BMD(a) in adults with a history of juvenile idiopathic arthritis (JIA).
  
  
  METHODS
  Men and women with a history of JIA attending a young adult rheumatology clinic in Newcastle, UK, underwent dual energy x-ray absorptiometry (DEXA) of the lumbar spine and total hip. Information was obtained about disease duration and subtype, previous treatment including corticosteroid and methotrexate therapy, and large-joint replacement. Subjects completed the modified Health Assessment Questionnaire (HAQ). Blood was taken for assessment of C-reactive protein, erythrocyte sedimentation rate, and rheumatoid factor (RF).
  
  
  RESULTS
  Seventy-one women and 16 men, mean age 28.7 and 31.4 years, and mean disease duration 20.6 and 24.0 years, respectively, were studied. Mean BMD(a) was 0.982 (Z-score = -0.328; 95% CI -0.657, 0.001) and 1.028 g/cm(2) (Z-score = -0.251; 95% CI -1.266, 0.764) in women and men, respectively, at the spine and 0.817 (Z-score = -0.542; 95% CI -0.975, -0.109) and 0.857 g/cm(2) (Z-score = -0.176; 95% CI -2.323, 1.971) at the hip. After adjusting for age and sex, increasing HAQ score was associated with both lower spine BMD(a) and hip BMD(a). Compared with patients with oligoarticular disease, those with enthesitis-related arthritis had higher BMD(a) at the spine, while those with extended oligoarticular and polyarticular RF-negative disease had lower hip BMD(a). Oral corticosteroids and the presence of a large-joint replacement were associated with lower BMD(a) at both the spine and hip.
  
  
  CONCLUSIONS
  There was a trend toward low BMD(a) in women with a history of JIA. These patients may be at risk of the complications of osteoporosis including fragility fractures and should be considered for targeted preventive measures.
authors.affiliation: Arthritis Research UK Epidemiology Unit, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom.
authors.forename: Judith
authors.initials: J
authors.lastname: Thornton
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Pye
authors.forename: Terence W
authors.initials: TW
authors.lastname: O'Neill
authors.forename: David
authors.initials: D
authors.lastname: Rawlings
authors.forename: Roger M
authors.initials: RM
authors.lastname: Francis
authors.forename: Deborah P M
authors.initials: DP
authors.lastname: Symmons
authors.forename: Darren M
authors.initials: DM
authors.lastname: Ashcroft
authors.forename: Helen E
authors.initials: HE
authors.lastname: Foster
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D001171:Arthritis, Juvenile / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D001799:Blood Sedimentation; D015992:Body Mass Index; D015519:Bone Density; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology; D012217:Rheumatoid Factor / Q000097:blood; D012307:Risk Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein; D012217:Rheumatoid Factor