Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome
Children with idiopathic nephrotic syndrome are primarily treated with glucocorticoids (GCs), but long-term GC use can lead to undesired side effects. We investigated the bone mineral density (BMD) and 25-hydroxyvitamin D (25-OH D) levels in children with the remission phase of steroid-sensitive nep...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2019-01-01
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| Series: | Saudi Journal of Kidney Diseases and Transplantation |
| Online Access: | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2019;volume=30;issue=4;spage=853;epage=862;aulast=Cetin |
| _version_ | 1818178979205480448 |
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| author | Nuran Cetin Aylin Gencler Ilknur Ak Sivrikoz |
| author_facet | Nuran Cetin Aylin Gencler Ilknur Ak Sivrikoz |
| author_sort | Nuran Cetin |
| collection | DOAJ |
| description | Children with idiopathic nephrotic syndrome are primarily treated with glucocorticoids (GCs), but long-term GC use can lead to undesired side effects. We investigated the bone mineral density (BMD) and 25-hydroxyvitamin D (25-OH D) levels in children with the remission phase of steroid-sensitive nephrotic syndrome (SSNS). This study included 32 patients with SSNS who had not received GC treatment in the last 6 months and a control group of 20 healthy children. Serum levels of calcium, phosphate, alkaline phosphatase, 25-(OH)D, and parathyroid hormone (PTH) were measured. BMD was determined in the lumbar spinal region using dual-energy X-ray absorptiometry (DEXA). Serum 25-(OH)D levels were lower in the SSNS patients than in the healthy children (P <0.05), with 22 patients (68.8%) having Z-scores <-1. The Z-scores were positively correlated with 25-(OH)D levels (r = 0.424, P <0.05). PTH levels were higher in patients with osteoporosis than in patients with Z-scores ≥–1 (P <0.05). Bone mineral content and BMD were positively correlated with the age of diagnosis (P <0.01). Receiver-operating characteristic curve analysis showed that the cutoff value of 25-(OH)D levels for predicting low BMD was 14.67 ng/mL with a sensitivity of 90% and a specificity of 64%. The area under the curve (AUC ± standard error) was 0.868 ± 0.064 (95% confidence interval: 0.742–0.994, P = 0.001). Decreased 25-(OH)D levels and the negative effects of long-term GC treatment on BMD persist in SSNS remission phase. Levels of 25-(OH)D <14.67 ng/mL could predict abnormal DEXA scans in children with SSNS remission phase. |
| first_indexed | 2024-12-11T20:56:35Z |
| format | Article |
| id | doaj.art-c7e1a85d824a47928778eff5e728bfbb |
| institution | Directory Open Access Journal |
| issn | 1319-2442 |
| language | English |
| last_indexed | 2024-12-11T20:56:35Z |
| publishDate | 2019-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Kidney Diseases and Transplantation |
| spelling | doaj.art-c7e1a85d824a47928778eff5e728bfbb2022-12-22T00:51:06ZengWolters Kluwer Medknow PublicationsSaudi Journal of Kidney Diseases and Transplantation1319-24422019-01-0130485386210.4103/1319-2442.265461Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndromeNuran CetinAylin GenclerIlknur Ak SivrikozChildren with idiopathic nephrotic syndrome are primarily treated with glucocorticoids (GCs), but long-term GC use can lead to undesired side effects. We investigated the bone mineral density (BMD) and 25-hydroxyvitamin D (25-OH D) levels in children with the remission phase of steroid-sensitive nephrotic syndrome (SSNS). This study included 32 patients with SSNS who had not received GC treatment in the last 6 months and a control group of 20 healthy children. Serum levels of calcium, phosphate, alkaline phosphatase, 25-(OH)D, and parathyroid hormone (PTH) were measured. BMD was determined in the lumbar spinal region using dual-energy X-ray absorptiometry (DEXA). Serum 25-(OH)D levels were lower in the SSNS patients than in the healthy children (P <0.05), with 22 patients (68.8%) having Z-scores <-1. The Z-scores were positively correlated with 25-(OH)D levels (r = 0.424, P <0.05). PTH levels were higher in patients with osteoporosis than in patients with Z-scores ≥–1 (P <0.05). Bone mineral content and BMD were positively correlated with the age of diagnosis (P <0.01). Receiver-operating characteristic curve analysis showed that the cutoff value of 25-(OH)D levels for predicting low BMD was 14.67 ng/mL with a sensitivity of 90% and a specificity of 64%. The area under the curve (AUC ± standard error) was 0.868 ± 0.064 (95% confidence interval: 0.742–0.994, P = 0.001). Decreased 25-(OH)D levels and the negative effects of long-term GC treatment on BMD persist in SSNS remission phase. Levels of 25-(OH)D <14.67 ng/mL could predict abnormal DEXA scans in children with SSNS remission phase.http://www.sjkdt.org/article.asp?issn=1319-2442;year=2019;volume=30;issue=4;spage=853;epage=862;aulast=Cetin |
| spellingShingle | Nuran Cetin Aylin Gencler Ilknur Ak Sivrikoz Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome Saudi Journal of Kidney Diseases and Transplantation |
| title | Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome |
| title_full | Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome |
| title_fullStr | Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome |
| title_full_unstemmed | Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome |
| title_short | Bone mineral density and vitamin D status in children with remission phase of steroid-sensitive nephrotic syndrome |
| title_sort | bone mineral density and vitamin d status in children with remission phase of steroid sensitive nephrotic syndrome |
| url | http://www.sjkdt.org/article.asp?issn=1319-2442;year=2019;volume=30;issue=4;spage=853;epage=862;aulast=Cetin |
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