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Prevalence and Risk Factors of Low Bone Mineral Density in Juvenile Onset Ankylosing Spondylitis

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Abstract

The objective of this study is to assess the prevalence and risk in patients with juvenile onset ankylosing spondylitis (JoAS) complicated with low bone mineral density (BMD). A total of 112 children and adolescents with JoAS were enrolled in the study. Bone mass was measured from the lumbar spine and the left proximal femur using dual-energy X-ray absorptiometry. According to the 2007 International Society of Clinical Densitometry definitions, a Z score of less than −2 was termed as “low BMD.” Stepwise regression analysis was used to investigate associations between low BMD and disease-related factors including gender, age, weight, height, body mass index, disease duration, HLA-B27 antigen, grades of sacroiliitis, Bath AS Disease Activity Index (BASDAI), Bath AS Functional Index (BASFI), patient global assessment (PGA), spine pain, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Low BMD was found in 18 (16.1 %) cases in at least one of the two measured regions. Lumbar spine BMD had negative correlations with BASDAI, BASFI, spine pain, ESR, and CRP (P < 0.05). Hip BMD significantly negatively correlated with BASDAI and PGA (P < 0.05). In conclusion, patients with JoAS are likely to develop low BMD, which may be related to high disease activity.

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Abbreviations

aBMD:

Areal bone mineral density

AS:

Ankylosing spondylitis

ASAS:

Assessment in SpondyloArthritis International Society

BASDAI:

Bath Ankylosing Spondylitis Disease Activity Index

BASFI:

Bath Ankylosing Spondylitis Functional Index

BMD:

Bone mineral density

BMI:

Body mass index

CRP:

C-reactive protein

DXA:

Dual-energy X-ray absorptiometry

ESR:

Erythrocyte sedimentation rate

ISCD:

International Society of Clinical Densitometry

JIA:

Juvenile idiopathic arthritis

JoAS:

Juvenile onset ankylosing spondylitis

mNY criteria:

Modified New York criteria

PDC:

Pediatric Position Development Conference

PGA:

Patient global assessment of disease activity

SD:

Standard deviation

SpA:

Spondyloarthritis

VAS:

Visual analog scale

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Acknowledgments

This study was supported in part by Grants from the National Natural Science Foundation of China (number 81172782).

Human and Animal Rights and Informed Consent

All procedures in the study were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

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Authors and Affiliations

  1. Department of Pediatrics, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai, 200092, China

    Jun Bao, Yi Chen & Yi-Xiao Bao

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  1. Jun Bao
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  2. Yi Chen
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  3. Yi-Xiao Bao
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Correspondence to Yi-Xiao Bao.

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Bao, J., Chen, Y. & Bao, YX. Prevalence and Risk Factors of Low Bone Mineral Density in Juvenile Onset Ankylosing Spondylitis. Calcif Tissue Int 95, 108–111 (2014). https://doi.org/10.1007/s00223-014-9867-2

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  • DOI: https://doi.org/10.1007/s00223-014-9867-2

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