title: Measurement of bone mineral density by dual energy X-ray absorptiometry in juvenile idiopathic arthritis.
abstract: OBJECTIVE
  To evaluate bone mineral density using dual X-ray absorptiometry in Juvenile Idiopathic Arthritis (JIA) patients and factors affecting it, if any.
  
  
  METHODS
  A cross sectional study was conducted by enrolling thirty five patients of JIA and age and sex matched controls. Bone Mineral Density (BMD) and Z score of whole body, total body less head, lumbar spine and distal radius were obtained and adjusted for age, sex, weight and BMI in both cases and controls. Dietary intake of calcium, vitamin D intake, sunlight exposure, weight bearing physical activity, age of onset, duration of disease, disease activity score and treatment received (prednisolone and methotrexate) were recorded.
  
  
  RESULTS
  BMD was significantly lower among patients as compared to controls. Decreased dietary intake of vitamin D and calcium, decreased weight bearing physical activity and sunlight exposure were the major factors for low BMD. Use of steroid also decreased BMD to some extent, whereas use of methotrexate, disease duration and severity did not have a significant correlation with BMD.
  
  
  CONCLUSIONS
  Apart from disease control, it is important to improve the dietary intake of calcium, vitamin D and encourage more physical activities and exposure to sunlight in JIA patients.
authors: Department of Pediatrics, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India.
authors: Soumya
authors: S
authors: Dey
authors: Afsana
authors: A
authors: Jahan
authors: Tribhuvan Pal
authors: TP
authors: Yadav
authors: Devesh Kumar
authors: DK
authors: Bhagwani
authors: Namrita
authors: N
authors: Sachdev
mesh_terms: D015502:Absorptiometry, Photon; D018501:Antirheumatic Agents / Q000494:pharmacology / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000188:drug therapy / Q000503:physiopathology*; D015519:Bone Density / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000494:pharmacology / Q000627:therapeutic use; D011239:Prednisolone / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D011239:Prednisolone; D008727:Methotrexate
references: J Rheumatol. 1991 Aug;18(8):1235-9
references: 1941831
references: Arthritis Rheum. 2005 Mar;52(3):833-40
references: 15751052
references: Arthritis Rheum. 2000 Mar;43(3):531-40
references: 10728745
references: Arthritis Rheum. 1999 Apr;42(4):790-8
references: 10211895
references: Arthritis Rheum. 1996 May;39(5):746-57
references: 8639171
references: J Rheumatol. 2006 Aug;33(8):1642-5
references: 16881120
references: J Osteoporos. 2011 Feb 20;2011:569417
references: 21403891
references: Arthritis Rheum. 2009 May 15;61(5):658-66
references: 19405003
references: J Clin Densitom. 2008 Jan-Mar;11(1):43-58
references: 18442752
references: Scand J Rheumatol. 2010 May;39(3):219-22
references: 20059447
references: J Pediatr. 1994 Jun;124(6):910-6
references: 8201475
references: Arch Dis Child. 1982 May;57(5):377-80
references: 6979977
references: Pediatr Clin North Am. 1995 Oct;42(5):1017-33
references: 7567184
references: Clinics (Sao Paulo). 2010;65(11):1197-205
references: 21243296
references: Pediatr Clin North Am. 2005 Apr;52(2):413-42, vi
references: 15820374
references: Osteoporos Int. 1999;10(1):20-5
references: 10501775
references: Indian J Pediatr. 2008 Mar;75(3):239-43
references: 18376091