TY - JOUR
T1 - Abnormalities in serum osteocalcin values in children with chronic rheumatic diseases
AU - Reed, Ann
AU - Haugen, Maureen
AU - Pachman, Lauren M.
AU - Langman, Craig B.
N1 - Funding Information:
Children with chronic rheumatic diseases, including juvenile rheumatoid arthritis, systemic lupus erythematosus, and juvenile dermatomyositis, have alterations in skeletal integrity\] demonstrated by both the presence of periartic- Supported in part by National Institutes of Health grants AR30692 and DK33949, by the Arthritis Foundation, and by the Otto Spra-gue Memorial Fund. Submitted for publication Dec. 27, t 988; accepted Oct. 26, 1989. Reprint requests: Craig B. Langman, MD, Mineral Metabolism Laboratory, Divisiono f Nephrology, Box 37, Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614. 9/20/17740 ular bony destruction 2, 3 and the occurrence of generalized osteopenia. 48 The precise mechanisms that produce each of the bony changes in children with CRD are not completely understood but may involve abnormalities of mineral metabolism9,10 Corticosteroid-induced osteoporosis, the most frequent form of secondary osteoporosis in adults\]1 has often been ascribed as the cause of osteopenia in children with rheumatic diseases, although few studies have been performed. Additionally, some investigators have implicated immobilization1 2 as the cause of the osteopenic bone disease.
PY - 1990/4
Y1 - 1990/4
N2 - We studied bone mineral metabolism prospectively in 113 children with chronic rheumatic diseases (juvenile arthritis, systemic lupus erythematosus, and juvenile dermatomyositis) to determine the relationship of serum levels of osteocalcin to rheumatic disease activity and corticosteroid usage, and to determine, in part, the cause of osteopenia in this population. Disease activity was quantitated by historical, clinical, and serologic means and an activity score derived. The 113 children were divided according to the expression of their disease, which was active (group 1: mean score 3.42, mean erythrocyte sedimentation rate 28 mm/hr) or inactive (group 2: score 1.7, erythrocyte sedimentation rate 15 mm/hr) (p<0.02 group 1 vs group 2 for each value), or which remitted during the study (group 3). We found that serum levels of osteocalcin, but not those of ionized calcium, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and parathyroid hormone, were reduced in group 1 children even before corticosteroid therapy was employed. Children in both group 2 and group 3 had normal osteocalcin levels despite the use of corticosteroids. The reduced levels of osteocalcin were predictive of a reduction in bone mass measured by photon absorptiometry in 16 of 19 children so studied. We conclude that skeletal abnormalities that result in a reduced bone mass occur in the clinical course of the majority of children with active chronic rheumatic diseases, are associated with reduced osteocalcin levels, and are not related to the use of corticosteroids. Serum osteocalcin levels may be a sensitive marker for reduced osteoblast activity and bone formation in children with chronic rheumatic diseases.
AB - We studied bone mineral metabolism prospectively in 113 children with chronic rheumatic diseases (juvenile arthritis, systemic lupus erythematosus, and juvenile dermatomyositis) to determine the relationship of serum levels of osteocalcin to rheumatic disease activity and corticosteroid usage, and to determine, in part, the cause of osteopenia in this population. Disease activity was quantitated by historical, clinical, and serologic means and an activity score derived. The 113 children were divided according to the expression of their disease, which was active (group 1: mean score 3.42, mean erythrocyte sedimentation rate 28 mm/hr) or inactive (group 2: score 1.7, erythrocyte sedimentation rate 15 mm/hr) (p<0.02 group 1 vs group 2 for each value), or which remitted during the study (group 3). We found that serum levels of osteocalcin, but not those of ionized calcium, 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, and parathyroid hormone, were reduced in group 1 children even before corticosteroid therapy was employed. Children in both group 2 and group 3 had normal osteocalcin levels despite the use of corticosteroids. The reduced levels of osteocalcin were predictive of a reduction in bone mass measured by photon absorptiometry in 16 of 19 children so studied. We conclude that skeletal abnormalities that result in a reduced bone mass occur in the clinical course of the majority of children with active chronic rheumatic diseases, are associated with reduced osteocalcin levels, and are not related to the use of corticosteroids. Serum osteocalcin levels may be a sensitive marker for reduced osteoblast activity and bone formation in children with chronic rheumatic diseases.
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U2 - 10.1016/S0022-3476(05)81605-1
DO - 10.1016/S0022-3476(05)81605-1
M3 - Article
C2 - 2319404
AN - SCOPUS:0025271015
SN - 0022-3476
VL - 116
SP - 574
EP - 580
JO - The Journal of Pediatrics
JF - The Journal of Pediatrics
IS - 4
ER -