Anette Lundestad, Lena Cetrelli, Oskar Welander Angenete, Thomas Angell Augdal, Karin Tylleskär, Ellen Berit Nordal, Karen Rosendahl, Gry Børmark Hoftun, Mari Hoff, Pål Richard Romundstad, Marite Rygg
{"title":"基于挪威的一项观察性研究，将青少年特发性关节炎患者的骨骼健康与对照组进行比较。","authors":"Anette Lundestad, Lena Cetrelli, Oskar Welander Angenete, Thomas Angell Augdal, Karin Tylleskär, Ellen Berit Nordal, Karen Rosendahl, Gry Børmark Hoftun, Mari Hoff, Pål Richard Romundstad, Marite Rygg","doi":"10.1136/rmdopen-2025-005605","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Children with juvenile idiopathic arthritis (JIA) are at risk for impaired bone health. This study evaluates bone mineral density (BMD) and potential risk factors for reduced BMD.</p><p><strong>Methods: </strong>In the NorJIA study, Norwegian children with JIA, and age-matched and sex-matched controls participated in a multicentre cohort study with clinical examinations, questionnaires, imaging and blood tests. BMD was measured using dual-energy X-ray absorptiometry and adjusted for bone age. Standard descriptive statistics and t-tests were used.</p><p><strong>Results: </strong>205 children with JIA had BMD measured at two study visits, 2 years apart and 125 controls at the second visit. At visit 2, median age was 14.7 years (IQR 11.5-16.6). Median disease duration was 6.6 (IQR 4.7-10.4) years, 50.7% had used or were currently using biologic disease-modifying antirheumatic drugs and 25.9% had ever used systemic steroids. There were no substantial differences in BMD Z-scores between the JIA group and controls. Mean BMD Z-score L1-L4 in JIA was 0.0 (95% CI -0.1, 0.1) and in controls 0.1 (95% CI -0.1, 0.3). A robust association was seen between physical activity levels and BMD. In children with JIA, the mean BMD Z-score L1-L4 was -0.3 (95% CI -0.6, 0.0) in the low-activity group and 0.2 (95% CI 0.0, 0.4) in the high-activity group, with a similar trend in controls. Children with JIA were as physically active as controls.</p><p><strong>Conclusions: </strong>BMD Z-scores in JIA were similar to controls and positively associated with physical activity. This underlines the importance of early disease control, steroid-sparing medications and physical activity to optimise bone health.</p><p><strong>Trial registration number: </strong>NCT03904459.</p>","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 2","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182186/pdf/","citationCount":"0","resultStr":"{\"title\":\"Bone health in juvenile idiopathic arthritis compared with controls based on a Norwegian observational study.\",\"authors\":\"Anette Lundestad, Lena Cetrelli, Oskar Welander Angenete, Thomas Angell Augdal, Karin Tylleskär, Ellen Berit Nordal, Karen Rosendahl, Gry Børmark Hoftun, Mari Hoff, Pål Richard Romundstad, Marite Rygg\",\"doi\":\"10.1136/rmdopen-2025-005605\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Children with juvenile idiopathic arthritis (JIA) are at risk for impaired bone health. This study evaluates bone mineral density (BMD) and potential risk factors for reduced BMD.</p><p><strong>Methods: </strong>In the NorJIA study, Norwegian children with JIA, and age-matched and sex-matched controls participated in a multicentre cohort study with clinical examinations, questionnaires, imaging and blood tests. BMD was measured using dual-energy X-ray absorptiometry and adjusted for bone age. Standard descriptive statistics and t-tests were used.</p><p><strong>Results: </strong>205 children with JIA had BMD measured at two study visits, 2 years apart and 125 controls at the second visit. At visit 2, median age was 14.7 years (IQR 11.5-16.6). Median disease duration was 6.6 (IQR 4.7-10.4) years, 50.7% had used or were currently using biologic disease-modifying antirheumatic drugs and 25.9% had ever used systemic steroids. There were no substantial differences in BMD Z-scores between the JIA group and controls. Mean BMD Z-score L1-L4 in JIA was 0.0 (95% CI -0.1, 0.1) and in controls 0.1 (95% CI -0.1, 0.3). A robust association was seen between physical activity levels and BMD. In children with JIA, the mean BMD Z-score L1-L4 was -0.3 (95% CI -0.6, 0.0) in the low-activity group and 0.2 (95% CI 0.0, 0.4) in the high-activity group, with a similar trend in controls. Children with JIA were as physically active as controls.</p><p><strong>Conclusions: </strong>BMD Z-scores in JIA were similar to controls and positively associated with physical activity. This underlines the importance of early disease control, steroid-sparing medications and physical activity to optimise bone health.</p><p><strong>Trial registration number: </strong>NCT03904459.</p>\",\"PeriodicalId\":21396,\"journal\":{\"name\":\"RMD Open\",\"volume\":\"11 2\",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-06-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12182186/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"RMD Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/rmdopen-2025-005605\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"RMD Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/rmdopen-2025-005605","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：患有幼年特发性关节炎（JIA）的儿童存在骨骼健康受损的风险。本研究评估骨密度（BMD）和骨密度降低的潜在危险因素。方法：在NorJIA研究中，挪威JIA患儿以及年龄匹配和性别匹配的对照组参加了一项多中心队列研究，包括临床检查、问卷调查、影像学检查和血液检查。采用双能x线骨密度仪测量骨密度，并根据骨龄进行调整。采用标准描述性统计和t检验。结果：205名JIA患儿在两次研究访问时测量了骨密度，间隔2年，第二次访问时测量了125名对照。第2次就诊时，中位年龄为14.7岁（IQR为11.5-16.6）。中位病程为6.6年（IQR为4.7-10.4）年，50.7%曾使用或正在使用生物缓解疾病的抗风湿药物，25.9%曾使用过全身类固醇。JIA组与对照组的BMD z -评分无显著差异。JIA患者的平均BMD z -评分L1-L4为0.0 (95% CI -0.1, 0.1)，对照组为0.1 （95% CI -0.1, 0.3）。体力活动水平与骨密度之间存在密切联系。在JIA患儿中，低活动组的平均BMD Z-score L1-L4为-0.3 (95% CI -0.6, 0.0)，高活动组的平均BMD Z-score为0.2 (95% CI 0.0, 0.4)，对照组的趋势相似。JIA患儿的身体活动与对照组相同。结论：JIA患者的BMD z评分与对照组相似，且与体力活动呈正相关。这强调了早期疾病控制、类固醇药物和身体活动对优化骨骼健康的重要性。试验注册号：NCT03904459。
Bone health in juvenile idiopathic arthritis compared with controls based on a Norwegian observational study.
Background: Children with juvenile idiopathic arthritis (JIA) are at risk for impaired bone health. This study evaluates bone mineral density (BMD) and potential risk factors for reduced BMD.
Methods: In the NorJIA study, Norwegian children with JIA, and age-matched and sex-matched controls participated in a multicentre cohort study with clinical examinations, questionnaires, imaging and blood tests. BMD was measured using dual-energy X-ray absorptiometry and adjusted for bone age. Standard descriptive statistics and t-tests were used.
Results: 205 children with JIA had BMD measured at two study visits, 2 years apart and 125 controls at the second visit. At visit 2, median age was 14.7 years (IQR 11.5-16.6). Median disease duration was 6.6 (IQR 4.7-10.4) years, 50.7% had used or were currently using biologic disease-modifying antirheumatic drugs and 25.9% had ever used systemic steroids. There were no substantial differences in BMD Z-scores between the JIA group and controls. Mean BMD Z-score L1-L4 in JIA was 0.0 (95% CI -0.1, 0.1) and in controls 0.1 (95% CI -0.1, 0.3). A robust association was seen between physical activity levels and BMD. In children with JIA, the mean BMD Z-score L1-L4 was -0.3 (95% CI -0.6, 0.0) in the low-activity group and 0.2 (95% CI 0.0, 0.4) in the high-activity group, with a similar trend in controls. Children with JIA were as physically active as controls.
Conclusions: BMD Z-scores in JIA were similar to controls and positively associated with physical activity. This underlines the importance of early disease control, steroid-sparing medications and physical activity to optimise bone health.
期刊介绍：
RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
