Osteoporotic Fractures and Vertebral Body Reshaping in Children With Glucocorticoid-treated Rheumatic Disorders
| Autor: | Rosie Scuccimarri, Maya Scharke, Victor N. Konji, Leanne M Ward, Kristin Houghton, Robert Stein, Celia Rodd, Marie-Eve Robinson, Elizabeth Sykes, Brian C. Lentle, Anne Marie Sbrocchi, Nazih Shenouda, Frank Rauch, Julie Barsalou, Robert Couch, Kerry Siminoski, Mary Ann Matzinger, David A. Cabral, Paivi Miettunen, Johannes Roth, Adam M. Huber, Khaldoun Koujok, Elizabeth A. Cummings, Bianca Lang, Maggie Larché, Stephanie A. Atkinson, Jacob L. Jaremko, Claire LeBlanc, Nathalie Alos, Karen Watanabe Duffy, Josephine Ho, Roman Jurencak, Jinhui Ma |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Male Pediatrics Vertebral Body Bone density Endocrinology Diabetes and Metabolism Clinical Biochemistry Osteoporosis Biochemistry 0302 clinical medicine Endocrinology Bone Density Risk Factors adolescents Longitudinal Studies Prospective Studies rheumatic disorders Child Bone mineral glucocorticoids Incidence (epidemiology) Incidence bone density Prognosis Child Preschool Spinal Fractures Female Glucocorticoid medicine.drug medicine.medical_specialty Canada Adolescent 030209 endocrinology & metabolism Context (language use) Standard score 03 medical and health sciences children Internal medicine Rheumatic Diseases medicine Humans vertebral fractures Glucocorticoids business.industry Biochemistry (medical) Infant Newborn Infant medicine.disease 030101 anatomy & morphology business Body mass index Osteoporotic Fractures Follow-Up Studies |
| Zdroj: | Paediatrics Publications |
| ISSN: | 1945-7197 |
| Popis: | Context Osteoporotic fractures are an important cause of morbidity in children with glucocorticoid-treated rheumatic disorders. Objective This work aims to evaluate the incidence and predictors of osteoporotic fractures and potential for recovery over six years following glucocorticoid (GC) initiation in children with rheumatic disorders. Methods Children with GC-treated rheumatic disorders were evaluated through a prospective inception cohort study led by the Canadian STeroid-induced Osteoporosis in the Pediatric Population (STOPP) Consortium. Clinical outcomes included lumbar spine bone mineral density (LS BMD), vertebral fractures (VF), non-VF, and vertebral body reshaping. Results A total of 136 children with GC-treated rheumatic disorders were enrolled (mean age 9.9 years, SD 4.4). The 6-year cumulative fracture incidence was 16.3% for VF, and 10.1% for non-VF. GC exposure was highest in the first 6 months, and 24 of 38 VF (63%) occurred in the first 2 years. Following VF, 16 of 19 children (84%) had complete vertebral body reshaping. Increases in disease activity and body mass index z scores in the first year and declines in LS BMD z scores in the first 6 months predicted incident VF over the 6 years, while higher average daily GC doses predicted both incident VF and non-VF. LS BMD z scores were lowest at 6 months (mean –0.9, SD 1.2) and remained low by 6 years even when adjusted for height z scores (–0.6, SD 0.9). Conclusion VF occurred early and were more common than non-VF in children with GC-treated rheumatic disorders. Eighty-four percent of children with VF underwent complete vertebral body reshaping, whereas vertebral deformity persisted in the remainder of children. On average, LS BMD z scores remained low at 6 years, consistent with incomplete recovery. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|