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Effect of the Glucocorticoids on the Vertebral Bone Density in Children with the Nephrotic Syndrome

Journal of the Korean Pediatric Society 1955;38(7):946-954.
Effect of the Glucocorticoids on the Vertebral Bone Density in Children with the Nephrotic Syndrome
Jong Young Kim, Yong Hoon Park
Department of Pediatrics, Yeungnam University Hospital, Taegu, Korea
신증후군 환아에서 스데로이드 치료에 의한 골밀도의 변화
김종영, 박용훈
영남대학교 의과대학 소아과학교실
Abstract
Purpose
: This study was conducted to evaluate that long term glucocorticoid treatment in children with the nephrotic syndrome can produce a significant loss of bone mass by measuring of bone mineral density(BMD)
Methods
: We measured BMD at lumbar vertebra(L2-L4) using dual enegy X-ray absorptiom-etry in 36 patients with the nephrotic syndrome who were administered prednisolone over 6 months and in 36 normal controls who were matched in according to Tanner stage.
Results
: BMD(g/cm2) showed decreased level in the nephrotic syndrome at Tanner stage II (0.621¡¾0.154) and Tanner stage 111(0.718¡¾0.186)compared with normal control(0.858 0.121 and 0.970 0.105, p<0.01). There were significant correlations between BMD and duration of treatment(y = 1.052-0,019x, r = -0.70, p<0.01), cumulative dose of corticosteroid(y= 1.193 - 0.090x, r = -0.70, p< 0.01)and standard deviation score of height(y = 0.050 x 0.764, r = 0.15, p<0.05). But, there were no significant correlations between BMD and serum calcium, phosphorus, alkaline phosp-hatase and parathyroid hormone, respectively.
Conclusion
: BMD was decreased in children with nephrotic syndrome who received long term steroid treatment at Tanner stage II and III significantly. The diminution of BMD is correlated with duration of steroid administration, cumulative dose of steroid and retarded growth significantly.
Key Words: Nephrotic syndrome, Bone mineral density, Glucocorticoid


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