Bone Mineral Density Change in Children with Steroid-Sensitive Idiopathic Nephrotic Syndrome - A Longitudinal Follow-Up Study

原發性腎病症候群兒童之骨密度變化：一個縱向追蹤研究結果

鍾林輝(Lin-Huei Chung) ； 傅令嫻(Lin-Shien Fu) ； 藍顥章(Howard Hau-Chang Lang) ； 徐山靜(Shang-Jing Shu) ； 遲景上(Ching-Shiang Chi)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 330-330

並列摘要

Aim 1. To compare the bone mineral density (BMD) in steroid-sensitive nephritic syndrome(SSNS) children with normal control. 2. To find out the relationship between relapse frequency and BMD change during a 2.76-year longitudinal follow-up.
Patient and method. We collected 28 children with SSNS (male 11, female 17) for this study. The mean age was 10.71± 3.21 years. The average duration between onset age and the first BMD measurement time was 3.01±2.53 years (range 0-10 years). The average period of time between their first and second BMD test was 2.76±0.77years (range:1.7 – 3.9years). the average relapse frequency during the period between the two BMD test time was 1.30±1.55 per year. Of total 28 children which were divide into two groups: 12 children (42.8%) had relapse frequency ＞1 per year (Group 1: average frequency 2.65 per year); another 16(57.2%) had relapse frequency ≤1 per year (Group 2: average frequency 0.37 per year). We used dual-energy X-ray absorptive (DEXA) method for BMD measurement. There were also 240normal children with age 4-18 years to be controls. Data were analyzed by multiple regression method to obtain a formula by age, sex and body weight. The difference value between actual and expected BMD (residual BMD) of first and second measurements in two groups were assessed to find out the relationship between relapse frequency and BMD change.
Results. BMD of total 28 SSNS children in two measurements were both significantly lower than normal controls [ the firs: (0.692± 0.111 / cm2) vs (0.781±0.144 /cm2), p＜0.05;and the second: (0.835± 0.176/cm2) vs (0.919± v0.166 /cm2),p＜0.05]. The first residual BMD in Group 1 and 2 were:(-0.104±0.107 /cm2) vs (-0.088± 0.131 /cm2). The second residual BMD were: (-0.134± 0.128 /cm2) vs (-0.1104±0.145 /cm2). The difference value of residual BMD between two measurements (second-first) in two groups were: (-0.030± 0.080 /cm2) vs (0.041± 0.073 /cm2), p=0.03.
Conclusion. 1.BMD is significantly decreased in those with SSNS. 2.There was no significant difference between two residual BMD, that means there was no significant improvement or worsening in BMD. 3. The group with relapse frequency ＞ 1 per year had a higher tendency for BMD loss than that with relapse frequency ≤1 per year.