Phan, V., Blydt-Hansen, T., Feber, J., Alos, N., Arora, S., Atkinson, S., Bell, L., Clarson, C., Couch, R., Cummings, E. A., Filler, G., Grant, R. M., Grimmer, J., Hebert, D., Lentle, B., Ma, J., Matzinger, M., Midgley, J., Pinsk, M., ... Reed, M. (2014). Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome. Osteoporosis International, 25(2), 627-637. https://doi.org/10.1007/s00198-013-2466-7
Phan, V, Blydt-Hansen, T, Feber, J, Alos, N, Arora, S, Atkinson, S, Bell, L, Clarson, C, Couch, R, Cummings, EA, Filler, G, Grant, RM, Grimmer, J, Hebert, D, Lentle, B, Ma, J, Matzinger, M, Midgley, J, Pinsk, M, Rodd, C, Shenouda, N, Stein, R, Stephure, D, Taback, S, Williams, K, Rauch, F, Siminoski, K, Ward, LM, Halton, J, Jurencak, R, Roth, J, Moher, D, Ramsay, T, Kloiber, R, Lewis, V, Miettunen, P, Cabral, D, Dix, DB, Houghton, K, Nadel, HR, Hay, J, Cairney, E, Sparrow, K, Fernandez, C, Huber, AM, Lang, B, O'Brien, K, Barr, R, Coblentz, C, Dent, PB, Larche, M, Webber, C, Abish, S, Scuccimarri, R, Glorieux, F, Dubois, J, Laverdière, C, Saint-Cyr, C, Ellsworth, J, LeBlanc, C, Wilson, B, Charron, M, Gaboury, I, Israels, S, Oen, K & Reed, M 2014, 'Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome', Osteoporosis International, vol. 25, no. 2, pp. 627-637. https://doi.org/10.1007/s00198-013-2466-7
@article{1c1d098d7a6b4cc3bcb3c7147708f859,
title = "Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome",
abstract = "Summary: Incident vertebral fractures and lumbar spine bone mineral density (BMD) were assessed in the 12 months following glucocorticoid initiation in 65 children with nephrotic syndrome. The incidence of vertebral fractures was low at 12 months (6%) and most patients demonstrated recovery in BMD Z-scores by this time point. Introduction: Vertebral fracture (VF) incidence following glucocorticoid (GC) initiation has not been previously reported in pediatric nephrotic syndrome. Methods: VF was assessed on radiographs (Genant method); lumbar spine bone mineral density (LS BMD) was evaluated by dual-energy X-ray absorptiometry. Results: Sixty-five children were followed to 12 months post-GC initiation (median age, 5.4 years; range, 2.3-17.9). Three of 54 children with radiographs (6%; 95% confidence interval (CI), 2-15%) had incident VF at 1 year. The mean LS BMD Z-score was below the healthy average at baseline (mean ± standard deviation (SD), -0.5±1.1; p=0.001) and at 3 months (-0.6±1.1; p<0.001), but not at 6 months (-0.3±1.3; p=0.066) or 12 months (-0.3±1.2; p=0.066). Mixed effect modeling showed a significant increase in LS BMD Z-scores between 3 and 12 months (0.22 SD; 95% CI, 0.08 to 0.36; p=0.003). A subgroup (N=16; 25%) had LS BMD Z-scores that were ≤-1.0 at 12 months. In these children, each additional 1,000 mg/m 2 of GC received in the first 3 months was associated with a decrease in LS BMD Z-score by 0.39 at 12 months (95% CI, -0.71 to -0.07; p=0.017). Conclusions: The incidence of VF at 1 year was low and LS BMD Z-scores improved by 12 months in the majority. Twenty-five percent of children had LS BMD Z-scores ≤-1.0 at 12 months. In these children, LS BMD Z-scores were inversely associated with early GC exposure, despite similar GC exposure compared to the rest of the cohort.",
author = "V. Phan and T. Blydt-Hansen and J. Feber and N. Alos and S. Arora and S. Atkinson and L. Bell and C. Clarson and R. Couch and Cummings, {E. A.} and G. Filler and Grant, {R. M.} and J. Grimmer and D. Hebert and B. Lentle and J. Ma and M. Matzinger and J. Midgley and M. Pinsk and C. Rodd and N. Shenouda and R. Stein and D. Stephure and S. Taback and K. Williams and F. Rauch and K. Siminoski and Ward, {Leanne M.} and Jacqueline Halton and Roman Jurencak and Johannes Roth and David Moher and Tim Ramsay and Reinhard Kloiber and Victor Lewis and Paivi Miettunen and David Cabral and Dix, {David B.} and Kristin Houghton and Nadel, {Helen R.} and John Hay and Elizabeth Cairney and Keith Sparrow and Conrad Fernandez and Huber, {Adam M.} and Bianca Lang and Kathy O'Brien and Ronald Barr and Craig Coblentz and Dent, {Peter B.} and Maggie Larche and Colin Webber and Sharon Abish and Rosie Scuccimarri and Francis Glorieux and Jos{\'e}e Dubois and Caroline Laverdi{\`e}re and Claire Saint-Cyr and Janet Ellsworth and Claire LeBlanc and Beverly Wilson and Martin Charron and Isabelle Gaboury and Sara Israels and Kiem Oen and Martin Reed",
note = "Funding Information: This study was primarily funded by an operating grant from the Canadian Institutes for Health Research (FRN 64285). Additional funding for this work has been provided to Dr. Leanne Ward by the Canadian Institutes for Health Research New Investigator Program, the Canadian Child Health Clinician Scientist Career Enhancement Program, a University of Ottawa Research Chair Award and the CHEO Departments of Pediatrics and Surgery. This work was also supported by the Children's Hospital of Eastern Ontario Research Institute and the University of Alberta Women and Children's Health Research Institute. ",
year = "2014",
month = feb,
doi = "10.1007/s00198-013-2466-7",
language = "English",
volume = "25",
pages = "627--637",
journal = "Osteoporosis International",
issn = "0937-941X",
publisher = "Springer London",
number = "2",
}
TY - JOUR
T1 - Skeletal findings in the first 12 months following initiation of glucocorticoid therapy for pediatric nephrotic syndrome
AU - Phan, V.
AU - Blydt-Hansen, T.
AU - Feber, J.
AU - Alos, N.
AU - Arora, S.
AU - Atkinson, S.
AU - Bell, L.
AU - Clarson, C.
AU - Couch, R.
AU - Cummings, E. A.
AU - Filler, G.
AU - Grant, R. M.
AU - Grimmer, J.
AU - Hebert, D.
AU - Lentle, B.
AU - Ma, J.
AU - Matzinger, M.
AU - Midgley, J.
AU - Pinsk, M.
AU - Rodd, C.
AU - Shenouda, N.
AU - Stein, R.
AU - Stephure, D.
AU - Taback, S.
AU - Williams, K.
AU - Rauch, F.
AU - Siminoski, K.
AU - Ward, Leanne M.
AU - Halton, Jacqueline
AU - Jurencak, Roman
AU - Roth, Johannes
AU - Moher, David
AU - Ramsay, Tim
AU - Kloiber, Reinhard
AU - Lewis, Victor
AU - Miettunen, Paivi
AU - Cabral, David
AU - Dix, David B.
AU - Houghton, Kristin
AU - Nadel, Helen R.
AU - Hay, John
AU - Cairney, Elizabeth
AU - Sparrow, Keith
AU - Fernandez, Conrad
AU - Huber, Adam M.
AU - Lang, Bianca
AU - O'Brien, Kathy
AU - Barr, Ronald
AU - Coblentz, Craig
AU - Dent, Peter B.
AU - Larche, Maggie
AU - Webber, Colin
AU - Abish, Sharon
AU - Scuccimarri, Rosie
AU - Glorieux, Francis
AU - Dubois, Josée
AU - Laverdière, Caroline
AU - Saint-Cyr, Claire
AU - Ellsworth, Janet
AU - LeBlanc, Claire
AU - Wilson, Beverly
AU - Charron, Martin
AU - Gaboury, Isabelle
AU - Israels, Sara
AU - Oen, Kiem
AU - Reed, Martin
N1 - Funding Information:
This study was primarily funded by an operating grant from the Canadian Institutes for Health Research (FRN 64285). Additional funding for this work has been provided to Dr. Leanne Ward by the Canadian Institutes for Health Research New Investigator Program, the Canadian Child Health Clinician Scientist Career Enhancement Program, a University of Ottawa Research Chair Award and the CHEO Departments of Pediatrics and Surgery. This work was also supported by the Children's Hospital of Eastern Ontario Research Institute and the University of Alberta Women and Children's Health Research Institute.
PY - 2014/2
Y1 - 2014/2
N2 - Summary: Incident vertebral fractures and lumbar spine bone mineral density (BMD) were assessed in the 12 months following glucocorticoid initiation in 65 children with nephrotic syndrome. The incidence of vertebral fractures was low at 12 months (6%) and most patients demonstrated recovery in BMD Z-scores by this time point. Introduction: Vertebral fracture (VF) incidence following glucocorticoid (GC) initiation has not been previously reported in pediatric nephrotic syndrome. Methods: VF was assessed on radiographs (Genant method); lumbar spine bone mineral density (LS BMD) was evaluated by dual-energy X-ray absorptiometry. Results: Sixty-five children were followed to 12 months post-GC initiation (median age, 5.4 years; range, 2.3-17.9). Three of 54 children with radiographs (6%; 95% confidence interval (CI), 2-15%) had incident VF at 1 year. The mean LS BMD Z-score was below the healthy average at baseline (mean ± standard deviation (SD), -0.5±1.1; p=0.001) and at 3 months (-0.6±1.1; p<0.001), but not at 6 months (-0.3±1.3; p=0.066) or 12 months (-0.3±1.2; p=0.066). Mixed effect modeling showed a significant increase in LS BMD Z-scores between 3 and 12 months (0.22 SD; 95% CI, 0.08 to 0.36; p=0.003). A subgroup (N=16; 25%) had LS BMD Z-scores that were ≤-1.0 at 12 months. In these children, each additional 1,000 mg/m 2 of GC received in the first 3 months was associated with a decrease in LS BMD Z-score by 0.39 at 12 months (95% CI, -0.71 to -0.07; p=0.017). Conclusions: The incidence of VF at 1 year was low and LS BMD Z-scores improved by 12 months in the majority. Twenty-five percent of children had LS BMD Z-scores ≤-1.0 at 12 months. In these children, LS BMD Z-scores were inversely associated with early GC exposure, despite similar GC exposure compared to the rest of the cohort.
AB - Summary: Incident vertebral fractures and lumbar spine bone mineral density (BMD) were assessed in the 12 months following glucocorticoid initiation in 65 children with nephrotic syndrome. The incidence of vertebral fractures was low at 12 months (6%) and most patients demonstrated recovery in BMD Z-scores by this time point. Introduction: Vertebral fracture (VF) incidence following glucocorticoid (GC) initiation has not been previously reported in pediatric nephrotic syndrome. Methods: VF was assessed on radiographs (Genant method); lumbar spine bone mineral density (LS BMD) was evaluated by dual-energy X-ray absorptiometry. Results: Sixty-five children were followed to 12 months post-GC initiation (median age, 5.4 years; range, 2.3-17.9). Three of 54 children with radiographs (6%; 95% confidence interval (CI), 2-15%) had incident VF at 1 year. The mean LS BMD Z-score was below the healthy average at baseline (mean ± standard deviation (SD), -0.5±1.1; p=0.001) and at 3 months (-0.6±1.1; p<0.001), but not at 6 months (-0.3±1.3; p=0.066) or 12 months (-0.3±1.2; p=0.066). Mixed effect modeling showed a significant increase in LS BMD Z-scores between 3 and 12 months (0.22 SD; 95% CI, 0.08 to 0.36; p=0.003). A subgroup (N=16; 25%) had LS BMD Z-scores that were ≤-1.0 at 12 months. In these children, each additional 1,000 mg/m 2 of GC received in the first 3 months was associated with a decrease in LS BMD Z-score by 0.39 at 12 months (95% CI, -0.71 to -0.07; p=0.017). Conclusions: The incidence of VF at 1 year was low and LS BMD Z-scores improved by 12 months in the majority. Twenty-five percent of children had LS BMD Z-scores ≤-1.0 at 12 months. In these children, LS BMD Z-scores were inversely associated with early GC exposure, despite similar GC exposure compared to the rest of the cohort.
UR - http://www.scopus.com/inward/record.url?scp=84899101601&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84899101601&partnerID=8YFLogxK
U2 - 10.1007/s00198-013-2466-7
DO - 10.1007/s00198-013-2466-7
M3 - Article
C2 - 23948876
AN - SCOPUS:84899101601
SN - 0937-941X
VL - 25
SP - 627
EP - 637
JO - Osteoporosis International
JF - Osteoporosis International
IS - 2
ER -