PT  - JOURNAL ARTICLE
AU  - JUDITH THORNTON
AU  - STEPHEN R. PYE
AU  - TERENCE W. O’NEILL
AU  - DAVID RAWLINGS
AU  - ROGER M. FRANCIS
AU  - DEBORAH P.M. SYMMONS
AU  - DARREN M. ASHCROFT
AU  - HELEN E. FOSTER
TI  - Bone Health in Adult Men and Women with a History of Juvenile Idiopathic Arthritis
AID  - 10.3899/jrheum.101232
DP  - 2011 Aug 01
TA  - The Journal of Rheumatology
PG  - 1689--1693
VI  - 38
IP  - 8
4099  - http://www.jrheum.org/content/38/8/1689.short
4100  - http://www.jrheum.org/content/38/8/1689.full
SO  - J Rheumatol2011 Aug 01; 38
AB  - Objective. Our aim was to determine areal bone mineral density (BMDa) and disease-related factors linked with BMDa 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 BMDa was 0.982 (Z-score = −0.328; 95% CI −0.657, 0.001) and 1.028 g/cm2 (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/cm2 (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 BMDa and hip BMDa. Compared with patients with oligoarticular disease, those with enthesitis-related arthritis had higher BMDa at the spine, while those with extended oligoarticular and polyarticular RF-negative disease had lower hip BMDa. Oral corticosteroids and the presence of a large-joint replacement were associated with lower BMDa at both the spine and hip. Conclusion. There was a trend toward low BMDa 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.