Bone mineral density in children and adolescents with systemic lupus erythematosus, juvenile dermatomyositis, and systemic vasculitis: relationship to disease duration, cumulative corticosteroid dose, calcium intake, and exercise.
Bibliographic record
Abstract
OBJECTIVE: To describe the frequency of abnormal bone mineralization in a population of children with juvenile systemic lupus erythematosus (JSLE), juvenile dermatomyositis (JDM), and systemic vasculitis; and to investigate the relationship of bone mineral density (BMD) to cumulative corticosteroid dose, disease duration, Tanner stage, calcium intake, and exercise in these patients. METHODS: A retrospective chart review of children attending the pediatric rheumatology clinic at British Columbia's Children's Hospital was conducted to obtain demographic data (sex, ethnicity, disease duration, cumulative corticosteroid dose, and mean daily corticosteroid dose). All patients had at least one BMD measurement by dual energy x-ray absorptiometry (DEXA) at lumbar spine, hip, and total body. BMD was expressed as g/cm2 and Z scores; an abnormal Z score was defined as </= -1.5. Daily calcium intake was calculated. Physical activity was scored using a validated 7 day physical activities questionnaire. RESULTS: A total of 36 patients were studied. Twenty-five patients had SLE, 7 had JDM, and 4 had systemic vasculitis. Fourteen subjects were Caucasian, 13 Asian, 6 East Indian, and 3 Canadian First Nations. An abnormal Z score at one or more sites was found in 10/25 (40%) with JSLE, and in 3/11 (27%) JDM/vasculitis patients. The mean Z scores (+/- SD) for lumbar spine were -1.02 (+/- 1.2), for hip -0.88 (+/- 1.3), and for total body -0.77 (+/- 1.5). Compared to children with normal bone densities, those with lower bone density tended to be younger (13.5 +/- 2.2 vs 15.5 +/- 1.7 yrs), received higher corticosteroid dosages at the time of the study (0.78 +/- 0.6 vs 0.35 +/- 0.2 mg/kg), and were more often prepubertal (OR for total body scores 5, 95% CI 0.7-46). CONCLUSION: Decreased bone density is common in children with SLE and other systemic rheumatic diseases. Age, corticosteroid dose, and pubertal stage all appear to have some influence on bone mass in these children.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".