Unidade de Reumatologia Pediátrica, Divisão de Alergia, Imunologia Clínica e Reumatologia, Departamento de Pediatria,Universidade Federal de São Paulo, São Paulo, SP, Brasil.
Braz J Med Biol Res. 2013 Jan;46(1):98-102. doi: 10.1590/1414-431x20122477. Epub 2013 Jan 11.
Our objective was to evaluate the concentrations of serum 25-hydroxyvitamin D [25(OH)D], serum calcium, serum phosphorus, alkaline phosphatase, and parathormone (PTH) in patients with polyarticular juvenile idiopathic arthritis (JIA) and to associate them with disease duration and activity, bone mineral density and use of medications. In a cross-sectional and controlled study, 30 patients with polyarticular JIA were evaluated and compared to 30 healthy individuals matched for age and gender. Clinical status, anthropometry, laboratory markers in both patients and controls, and bone mineral density, only in the patients, were measured. Of the 30 patients included in the study, 23 (76.7%) were female and 16 (53.3%) non-Caucasian; mean age was 14 years (range = 4 to 20 years). Mean disease duration was 5 years (range = 1 to 12 years). The mean concentrations of serum albumin-corrected calcium (9.04 ± 0.41 mg/dL) and alkaline phosphatase (153.3 ± 100.1 IU) were significantly lower in patients with JIA than in controls (P < 0.0001 and P = 0.001, respectively). No differences in 25(OH)D, PTH or serum phosphorus were observed between JIA and control subjects. Regarding 25(OH)D concentration, 8 patients (26.7%) and 5 controls (16.7%) had 25(OH)D concentrations compatible with deficiency (lower than 20 ng/mL) and 14 patients (46.7%) and 18 controls (60%) had concentrations compatible with insufficiency (20-32 ng/mL). These values were not associated with disease activity, use of medications or bone mineral density. We observed a high frequency of 25(OH)D insufficiency and deficiency in the study sample. The compromised bone metabolism emphasizes the importance of follow-up of JIA patients.
我们的目的是评估多关节型幼年特发性关节炎（JIA）患者血清 25-羟维生素 D [25(OH)D]、血清钙、血清磷、碱性磷酸酶和甲状旁腺激素（PTH）的浓度，并将其与疾病持续时间和活动度、骨密度以及药物使用相关联。在一项横断面对照研究中，评估了 30 例多关节型 JIA 患者，并与年龄和性别相匹配的 30 例健康个体进行了比较。测量了患者和对照组的临床状态、人体测量学、实验室标志物以及仅在患者中的骨密度。在纳入研究的 30 例患者中，23 例（76.7%）为女性，16 例（53.3%）为非白种人；平均年龄为 14 岁（范围=4 至 20 岁）。平均疾病持续时间为 5 年（范围=1 至 12 年）。JIA 患者血清白蛋白校正钙（9.04±0.41mg/dL）和碱性磷酸酶（153.3±100.1IU）的浓度明显低于对照组（P<0.0001 和 P=0.001）。JIA 患者与对照组之间的 25(OH)D、PTH 或血清磷无差异。关于 25(OH)D 浓度，8 例（26.7%）和 5 例（16.7%）JIA 患者的 25(OH)D 浓度与缺乏症（低于 20ng/mL）一致，14 例（46.7%）和 18 例（60%）JIA 患者的 25(OH)D 浓度与不足症（20-32ng/mL）一致。这些值与疾病活动度、药物使用或骨密度无关。在研究样本中，我们观察到 25(OH)D 不足和缺乏的发生率较高。受损的骨代谢强调了对 JIA 患者进行随访的重要性。
