Abstract
This study aimed to establish the characteristics of bone markers among pediatric patients with rheumatic
diseases． We examined correlations between bone markers and bone mineral density（BMD， and evaluated the
effect of glucocorticoid（GC）on their bone metabolism．58 %of the patients presented elevated bone resorption
marker（TRACP-5b， and only 8 % of them presented low bone formation marker (BAP)，which indicates their
bone resorption is increased and formation is not suppressed． Although patients with GC therapy have Lower
BMD， their bone markers are not significantly different from those without GC therapy． In addition to GC
treatment， inflammatory cytokines and reduced physical activity also appear to contribute to the bone fragility．
Considering pathophysiology of these patients． bisphosphonates are good candidates to prevent GC-induced
osteoporosis． In conclusion， we have shown two unique aspects of bone metabolism of our patients． One is that
the bone resorption is increased in more than half of the cases． The other is that the patients with GC therapy
have lower BMD， but their bone markers are not significantly different from those without GC therapy． We need
to collect more follow-up data to establish a basis to start bisphosphonates and to evaluate the effect of them．
