AB1083 Clinical and densitometric characteristics in paediatric population with risk factors to develop low bone mass/osteoporosis

ANNALS OF THE RHEUMATIC DISEASES(2018)

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摘要
Background Low Bone Mass (LBM)/Paediatric Osteoporosis (Ped OP) is a disorder of unknown prevalence, partly due to the lack of diagnosis, associated with the absence of clinical manifestations of the disease until patients develop complications such as fractures, deformities or pain Objectives To describe the clinical and densitometric characteristics of the paediatric population with risk factors to develop LBM/Ped OP Methods We collected prospectively demographic and clinical data of patients aged 2 to 20 years, referred for bone health assessment due to the presence of a risk factors for LBM/Ped OP, including: inflammatory diseases, immunosuppressants and/or corticosteroids, malabsorptive diseases and chronic systemic disorders. We evaluated daily calcium intake and Bone Densitometry (DXA) was performed. We did also a vertebral morphometry Results Data were collected from 90 patients, with an average age of 9’9 years, 53% female, 82% Caucasian. The age distribution and calcium intake by age can be seen in table 1. There was a significant decrease in the compliance of the RDA with calcium with increasing age (p=0.01). No differences were found in the average daily calcium intake between the different diagnostic groups. The most frequent diagnoses were: Malabsorption:44.4%, JIA:20%, Nephropathies:17.8%, Haematological diseases:7.8% and Vasculitis: 4.4%. 18% of the sample had had a fracture (Fx), 44% of them had more than one, being the adolescents the group of greater prevalence. 3 cases met the criteria for fragility Fx (vertebral Fx). 20% of the patients were on systemic corticosteroids, with an average dose of 5.9 mg of prednisone (or equivalent)/day, and another 20% had previously received them. The total cumulative average corticosteroid dose in both groups was: 7 grams of prednisone, with an average exposure of 37 months. 29 patients (32%) received immunosuppressive treatment, of which 20% were methotrexate (alone or in combination with biological DMARD). Only 7% had supplements with Calcium and 14% with Vitamin D. 100% had a normal calcium, 82% a normal phosphate (rest slightly increased) and 11% were deficient in Vitamin D 13% of the sample had a LBM for their age assessed by DXA. The densitometric results can be seen in Table 2. Conclusions Calcium intake in children and young with at least 1 risk factor for LBM/Ped Op is lower than recommended, especially in the groups with the highest requirements. Up to 13% of this population have a BMO for their age and a 3’3% meets Ped OP criteria. Larger studies are needed to help us to identify paediatric patients who are candidates for bone health screening Disclosure of Interest None declared
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