الفهرس 
AIM OF THE WORKOnly 14 pages are availabe for public view
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Abstract
This study was performed to assess bone mineral density (BMD) and bone turnover markers (serum osteocalcin for bone formation and C terminal telopeptide of type 1 collagen (CTX) for bone resorption) in juvenile idiopathic arthritis patients and their relation to disease activity.
This study involved 50 patients with JIA (20 female & 30 male) with mean age of 12.81±3.15 and with mean disease duration of 3.63±2.11 years.
Patients are diagnosed as JIA according to the criteria of classification of the International League of Associations for Rheumatology [ILAR].
All patients were subjected to the following:
* Full history taking.
* Full detailed clinical examination.
*Laboratory assessment including bone turnover markers: serum osteocalcin for bone formation and C terminal telopeptide of type 1 collagen (CTX) for bone resorption.
*Assessment of disease activity using the Juvenile Arthritis Disease Activity Score (JADAS-27).
* Measurement of pediatric bone mineral density (BMD) using DEXA scan.
Summary & Conclusion
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The results showed the following:
There was a significant correlation between disease activity (JADAS-27) and serum osteocalcin and highly significant correlation between disease activity (JADAS-27) and serum CTX.
There was a significant correlation between disease activity (JADAS-27) and vitamin D3 level.
There was a highly significant difference between types of JIA regarding disease activity (JADAS-27), disease activity is higher in enthesitis related type and polyarticular RF +ve type of JIA.
There was a highly significant difference between vitamin D3 levels regarding disease activity (JADAS), disease activity is higher in vitamin D3 deficiency.
There was a highly significant correlation between bone mineral density (DEXA Z-score) and bone turnover markers (serum osteocalcin and CTX).
There was a highly significant difference between types of JIA and DEXA Z-score, DEXA Z-score is lower in enthesitis related type and polyarticular RF +ve type of JIA.
There was a significant difference between vitamin D3 levels and DEXA Z-score; DEXA Z-score is lower in vitamin D3 deficiency.
There was negative correlation between bone mineral density (DEXA Z-score) and disease activity (JADAS-27) with P-value <0.001.
Summary & Conclusion
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CONCLUSION:
Our study suggested that osteopenia and osteoporosis were frequent complications of JIA.
The pediatrician should be aware that osteoporosis is not only a disorder of adults but may also concern children affected by several disorders with onset in childhood.
DEXA Z-score provides a useful non-invasive technique to assess bone mineral density in JIA patients and will increase our diagnostic accuracy and provide invaluable tools for assessing different therapies.
Those JIA patients with lower BMD could be subjected to an increase in bone turnover.
Patients with higher disease activity are at a higher risk of osteopenia and osteoporosis.
Vitamin D deficiency may have effect on the disease activity of JIA and restoration of vitamin D deficiency may also positively affect the disease activity.
Well-timed and efficient treatment of JIA and proper control of disease activity may help to improve bone status and reduce incidence of osteoporosis.
Increased bone resorption marker (CTX) more than bone formation marker (osteocalcin) in JIA patients with high disease activity.