The association between lean mass and bone mineral content in the high disease activity group of adult patients with juvenile idiopathic arthritis

BMC Musculoskeletal Disorders

Jan J Stepan¹  Karel Pavelka¹  Katerina Jarosova¹  Kristyna Brabnikova Maresova¹ 

[1] First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic

关键词: Glucocorticoids;    Bone mineral content;    Bone mineral density;    Lean mass;    Body composition;    DAS 28;    Disease activity;    JIA in adults;   

Others  :  1128758
DOI  :  10.1186/1471-2474-15-51

 received in 2013-08-31, accepted in 2014-02-12,  发布年份 2014

【 摘 要 】

Background

The study is aimed to evaluate body composition and bone status in adolescent and adult patients with active juvenile idiopathic arthritis (JIA) untreated with tumor necrosis factor alpha inhibitors.

Methods

Adult patients (12 male and 19 female) with active JIA and 84 healthy age- and gender- matched controls were enrolled into the study. Body composition (tissue mass in grams, lean mass, fat mass and bone mineral content as a fraction of tissue mass) and areal bone mineral density parameters (aBMD) at the lumbar spine, proximal femur, femoral neck, distal radius and total body were assessed using dual energy x-ray absorptiometry (DXA), and correlated with clinical characteristics of the disease and physical performance tests. Disease activity was assessed using high-sensitivity C-reactive protein (hsCRP) and disease activity score 28 (DAS 28). Differences between the groups were tested by t-test, and One-way ANOVA. Correlations were assessed using the Pearson correlation coefficients and multiple linear regression analysis. Significances were counted at the 0.05 level.

Results

In patients with clinically active JIA (DAS 28, 6.36 ± 0.64, hsCRP, 18.36 ± 16.95 mg/l), aBMD at all measured sites, bone mineral content (BMC) and lean mass were reduced, and fat mass was increased as compared with healthy controls. Significant negative correlations were observed between BMC and disease duration, use of glucocorticoids (GCs), and fat mass, respectively. A positive correlation was found between BMC and lean mass, and between the body fat fraction and the use of GCs. Using multiple linear regression analysis, lean mass was the only significant predictor of BMC of total body both in men and women, and of BMC of legs (only in men). Lean mass was also the only predicting factor of total proximal femur BMD and femoral neck BMD. No significant correlations have been determined among the body composition parameters and DAS 28 or hsCRP endpoints.

Conclusions

In adult patients with long-term active JIA, lean mass was the main determining factor of total body and leg BMC, and total proximal femur and femoral neck aBMD.

【 授权许可】

   
2014 Brabnikova Maresova et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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