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Ann Pediatr Endocrinol Metab Search


Ann Pediatr Endocrinol Metab > Volume 28(1); 2023 > Article
DOI: https://doi.org/10.6065/apem.2244026.013    Published online June 28, 2022.
Factors affecting bone mineral density in children and adolescents with secondary osteoporosis
Min Jeong Jang  , Chungwoo Shin  , Seongkoo Kim  , Jae Wook Lee  , Nack-Gyun Chung  , Bin Cho  , Min Ho Jung  , Byung-Kyu Suh  , Moon Bae Ahn 
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
Address for correspondence:  Moon Bae Ahn
Email: mbahn@catholic.ac.kr
Received: February 4, 2022   Revised: March 16, 2022   Accepted: March 29, 2022
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.
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.
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.
Initial bone mass density of the lumbar spine evaluated after long-term GC use for underlying diseases is a predictor of further vertebral fractures.
Keywords: Secondary osteoporosis, Bone mineral density, Dual-energy x-ray absorptiometry


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