Bone health in adult men and women with a history of juvenile idiopathic arthritis

Judith Thornton, Stephen R. Pye, Terence W. O'Neill, David Rawlings, Roger M. Francis, Deborah P M Symmons, Darren M. Ashcroft, Helen E. Foster

    Research output: Contribution to journalArticlepeer-review


    Objective. Our aim was to determine areal bone mineral density (BMD a) and disease-related factors linked with BMD a in adults with a history of juvenile idiopathic arthritis (JIA). Methods. Men and women with a history of JIA attending a young adult rheumatology clinic in Newcastle, UK, underwent dual energy x-ray absorptiometry (DEXA) of the lumbar spine and total hip. Information was obtained about disease duration and subtype, previous treatment including cortico - steroid and methotrexate therapy, and large-joint replacement. Subjects completed the modified Health Assessment Questionnaire (HAQ). Blood was taken for assessment of C-reactive protein, erythrocyte sedimentation rate, and rheumatoid factor (RF). Results. Seventy-one women and 16 men, mean age 28.7 and 31.4 years, and mean disease duration 20.6 and 24.0 years, respectively, were studied. Mean BMD a was 0.982 (Z-score = -0.328; 95% CI -0.657, 0.001) and 1.028 g/cm 2 (Z-score = -0.251; 95% CI -1.266, 0.764) in women and men, respectively, at the spine and 0.817 (Z-score = -0.542; 95% CI -0.975, -0.109) and 0.857 g/cm 2 (Z-score = -0.176; 95% CI -2.323, 1.971) at the hip. After adjusting for age and sex, increasing HAQ score was associated with both lower spine BMD a and hip BMD a. Compared with patients with oligoarticular disease, those with enthesitis-related arthritis had higher BMDa at the spine, while those with extended oligoarticular and polyarticular RF-negative disease had lower hip BMD a. Oral corticosteroids and the presence of a large-joint replacement were associated with lower BMD a at both the spine and hip. Conclusion. There was a trend toward low BMD a in women with a history of JIA. These patients may be at risk of the complications of osteoporosis including fragility fractures and should be considered for targeted preventive measures. The Journal of Rheumatology Copyright © 2011. All rights reserved.
    Original languageEnglish
    Pages (from-to)1689-1693
    Number of pages4
    JournalJournal of Rheumatology
    Issue number8
    Publication statusPublished - Aug 2011


    • Areal bone mineral density
    • Fracture
    • Juvenile idiopathic arthritis
    • Risk factors


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