Factors affecting bone mineral density in children and adolescents with secondary osteoporosis

Jang Min Jeong; Shin Chungwoo; Kim Seongkoo; Lee Jae Wook; Chung Nack-Gyun; Cho Bin; Jung Min Ho; Suh Byung-Kyu; Ahn Moon Bae

doi:10.6065/apem.2244026.013

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자료유형: 학술저널

저자정보: Jang Min Jeong (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea) Shin Chungwoo (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea) Kim Seongkoo (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea) Lee Jae Wook (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea.) Chung Nack-Gyun (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea.) Cho Bin (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea.) Jung Min Ho (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea) Suh Byung-Kyu (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea.) Ahn Moon Bae (Department of Pediatrics College of Medicine The Catholic University of Korea Seoul Korea.)

저널정보: 대한소아내분비학회 Annals of Pediatirc Endocrinology & Metabolism Annals of Pediatric Endocrinology & Metabolism 제28권 제1호

발행연도: 2023.3

수록면: 34 - 41 (8page)

DOI: 10.6065/apem.2244026.013

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Purpose: This study aimed to investigate the clinical factors associated with bone mineral density (BMD) among children and adolescents with osteoporosis secondary to treatment for underlying clinical conditions.Methods: We retrospectively reviewed the medical records of patients aged 10–18 years and evaluated them for lumbar spine BMD (LSBMD) after treatment for underlying diseases, including hemato-oncologic, rheumatologic system, and inflammator y bowel diseases. LSBMD measured by dual-energy x-ray absorptiometry (DXA) performed from March 2019 to March 2021 was evaluated. We analyzed 117 patients who underwent initial DXA after treatment for underlying diseases.Results: Subjects in this study had multiple underlying diseases: hemato-oncologic (78.6%), rheumatologic (11.1%), and inflammatory bowel diseases (10.3%). There was no significant association between the z-score and bone metabolic markers (P>0.05). However, higher cumulative glucocorticoid (GC) dose significantly reduced LSBMD z-score (P=0.029). Moreover, the association between cumulative dose of GC and initial z-score of LSBMD was significant in logarithmic regression analysis (P=0.003, R2=0.149). GC accumulation was a significant risk factor for vertebral fracture when the initial BMD was evaluated after treatment (P=0.043). Bone metabolic markers did not significantly influence the risk of vertebral fracture.Conclusion: Initial bone mass density of the lumbar spine evaluated after long-term GC use for underlying diseases is a predictor of further vertebral fractures.

#Secondary osteoporosis #Bone mineral density #Dual-energy x-ray absorptiometry

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