Osteopenia is common in adult male patients with active juvenile idiopathic arthritis

Abstract

OBJECTIVE: To assess the prevalence of osteopenia in Southeast Asian men with active juvenile idiopathic arthritis (JIA) and to identify predictors of reduced bone mineral density (BMD). METHODS: BMD of 30 men with active JIA and 23 healthy men was assessed by dual energy x-ray absorptiometry scans. Clinical variables that influence bone mass were also analyzed. T scores were calculated based on Caucasian normative data. RESULTS: Absolute BMD (g/cm(2)) was significantly lower in men with active JIA compared to controls at all measured sites, i.e., lumbar spine (p = 0.018), hip (p = 0.018), and distal third of forearm (p = 0.044). More subjects in the JIA group had low BMD (T score < or= -1.0) than controls at hip (22/30 vs 9/23; p < 0.05) and distal third of forearm (27/30 vs 10/23; p < 0.001), while at lumbar spine region the difference was not statistically significant (22/30 vs 13/23). A significant negative correlation of BMD was found with joint deformities, limitation of joint movement, Health Assessment Questionnaire score, and erythrocyte sedimentation rate. BMD at the hip and distal third of forearm was significantly lower in patients having arthritis at these sites. A positive correlation of BMD was found with body mass index. CONCLUSION: A majority of Southeast Asian men with active JIA have reduced BMD. More patients in our cohort had low BMD compared to reports from Western countries. This finding may be attributed to use of Caucasian normative data, uncontrolled disease activity, severity of disease, poor nutritional status, or an ethnic variation.