Characteristic　associations　between　bone　turnover　markers （BAP　and　TRACP-5b）and　bone　density　among pediatric　patients　with　rheumatic　diseases．

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．