Evaluation of glucocorticoid-induced osteoporosis in childhood kidney diseases by quantitative ultrasound

Abstract

Objective To observe the glucocorticoid-induced osteoporosis(GIOP) in children with kidney diseases by quantitative ultrasound(QUS), and to analyze its influencing factors. Methods The tibia/radius bone mineral density(BMD) was checked obtained in 67 cases with childhood kidney diseases treated with glucocorticoid by QUS, BMD was measured in children over the age of 12 by dual-energy X-ray absorptiometry(DXEA), and BMD was measured with QUS consistency and different stages of osteoporsis were compared.The clinical data of gender, age, body mass index(BMI), administration duration and daily dosage of glucocorticoid were analyzed.The association between the duration of glucocorticoid use, and daily dosage of glucocorticoid and the different degrees of BMD was analyzed by Logistic regression analysis. Results Sixty-seven patients(male 45, female 22) were divided into 4 groups according to the reference standard of Asian children BMD data provided by Sunlight Company: the normal BMD group(41 cases), the mild osteoporosis group(18 cases), moderate osteoporosis group(5 cases), and severe osteoporosis group(3 cases). Both QUS and DEXA were highly correlated with BMD in patients measured(P>0.05). The duration of glucocorticoid treatment and daily dosage of glucocorticoid in 3 abnormal BMD groups were all significantly longer and larger than those of the normal BMD group(all P<0.05). Correlation analysis showed that BMI was positively correlated with the bone mass of the tibia(r=0.395, P<0.01). The duration of glucocorticoid treatment and daily dosage of glucocorticoid were negatively correlated with those of radius BMD(r=-0.474, -0.381, all P<0.01). Analysis showed that both the duration of glucocorticoid, and the daily dosage of glucocorticoid were the risk factors for GIOP. Conclusions QUS is a better method for evaluating of BMD and diagnosing of GIOP compared with DEXA in children.The daily dosage of glucocorticoid and the duration of glucocorticoid treatment are both the risk factors for GIOP. Key words: Glucocorticoid; Osteoporosis; Quantitative ultrasound; Tibia; Radius