Bodycomposition, bone mineral density and serum adipokines in juvenile idiopathic arthritis with previous glucocorticoid therapy

Abstract

Introduction: Patients with juvenile idiopathic arthritis (JIA) are prone to alterations in bone health, body composition and adipokines. Objectives: To evaluate areal bone mineral density (BMD), body composition and serum leptin and adiponectin levels in patients with JIA and healthy controls. Methods: Study cohort comprised 50 patients with JIA (34 girls, median age 12.7 and range 7.4-17.4 years, median disease duration 6.3 and range 2.0-15.1 years) previously exposed to systemic glucocorticoids for a minimum of three months (range 0.2-12.5 years). Study protocol included clinical examination, bone age determination, BMD and body composition measurements with dual X-ray absorptiometry (DXA), and assessment of fasting serum leptin and adiponectin. Comparison with age-and gender-matched healthy controls (n=88) was performed. Results: Height, weight, BMI, pubertal stage, fat mass and lean mass were similar. Patients had lower Z-scores for whole body and bone-agecorrected lumbar spine BMD (p<0.001 and 0.009). Their whole body BMC to lean mass ratio was lower. Serum leptin and adiponectin were similar between groups even when adjusted for age and fat mass, and no correlations with disease activity occurred. Patients (n=16) with low LS BMD (