{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:27:57Z","timestamp":1785788877188,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,28]],"date-time":"2020-12-28T00:00:00Z","timestamp":1609113600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Glucocorticoids (GC) are essential medicines for idiopathic steroid\u2010sensitive nephrotic syndrome (ISSNS) and IgA nephropathy (IgAN), with good clinical results. However, they cause bone fragility. The aim of this study was to elucidate GC effects on bone strength assessed as bone mineral density (BMD) and bone quality, using bone turnover markers (BTM), in children with ISSNS or IgAN.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eleven children with ISSNS and 13 with IgAN were included. All the patients received GC treatment according to each protocol. The BMD and BTM\u2014serum alkaline phosphatase (S\u2010ALP), tartrate\u2010resistant acid phosphatase 5b (S\u2010TRACP\u20105b), and undercarboxylated osteocalcin (S\u2010ucOC)\u2014were measured from the initiation of steroid treatment (STx) to the end of STx in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In ISSNS, S\u2010ALP and S\u2010ucOC levels were decreased significantly at 1 month. BMD and S\u2010TRACP\u20105b levels showed no significant change through this observation period. In IgAN, BMD and S\u2010ALP levels were decreased significantly at 1 and 3 months, respectively, and recovered to baseline at 10 months after the initiation of GC dosage reduction. S\u2010TRACP\u20105b levels were decreased significantly at 3 months and remained lower than at baseline through the observation period. In both groups, S\u2010ucOC levels did not directly reflect bone strength.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study clarified the following three points regarding GC effects on bone strength in children with ISSNS or IgAN: first, S\u2010ALP is a more sensitive bone quality marker than S\u2010TRACP\u20105b; second, BMD loss was observed only when both S\u2010ALP and S\u2010TRACP\u20105b levels decreased, and third, S\u2010ucOC levels do not directly reflect bone strength.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13832","type":"journal-article","created":{"date-parts":[[2020,11,18]],"date-time":"2020-11-18T23:06:14Z","timestamp":1605740774000},"page":"119-125","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Glucocorticoid effects on bone strength in children with renal 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