{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T21:25:53Z","timestamp":1793741153372,"version":"4.6.1"},"reference-count":48,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T00:00:00Z","timestamp":1750291200000},"content-version":"unspecified","delay-in-days":79,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Nansen Funds"},{"name":"Research grants from St. Olavs hospital and NTNU."},{"name":"The Foundation Dam"},{"name":"Grants from the Joint Research Committee between St. Olavs Hospital and the Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway"},{"name":"The Norwegian Directorate of Health, through their financial support for research at the regional Centers for Oral Health Services and Research in Norway."}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2025,5,12]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Children with juvenile idiopathic arthritis (JIA) are at risk for impaired bone health. This study evaluates bone mineral density (BMD) and potential risk factors for reduced BMD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In the NorJIA study, Norwegian children with JIA, and age-matched and sex-matched controls participated in a multicentre cohort study with clinical examinations, questionnaires, imaging and blood tests. BMD was measured using dual-energy X-ray absorptiometry and adjusted for bone age. Standard descriptive statistics and t-tests were used.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>205 children with JIA had BMD measured at two study visits, 2 years apart and 125 controls at the second visit. At visit 2, median age was 14.7 years (IQR 11.5\u201316.6). Median disease duration was 6.6 (IQR 4.7\u201310.4) years, 50.7% had used or were currently using biologic disease-modifying antirheumatic drugs and 25.9% had ever used systemic steroids. There were no substantial differences in BMD Z-scores between the JIA group and controls. Mean BMD Z-score L1-L4 in JIA was 0.0 (95% CI \u22120.1, 0.1) and in controls 0.1 (95% CI \u22120.1, 0.3). A robust association was seen between physical activity levels and BMD. In children with JIA, the mean BMD Z-score L1-L4 was \u22120.3 (95% CI \u22120.6, 0.0) in the low-activity group and 0.2 (95% CI 0.0, 0.4) in the high-activity group, with a similar trend in controls. Children with JIA were as physically active as controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>BMD Z-scores in JIA were similar to controls and positively associated with physical activity. This underlines the importance of early disease control, steroid-sparing medications and physical activity to optimise bone health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03904459\">NCT03904459<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-005605","type":"journal-article","created":{"date-parts":[[2025,6,19]],"date-time":"2025-06-19T08:10:15Z","timestamp":1750320615000},"page":"e005605","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Bone health in juvenile idiopathic arthritis compared with controls based on a Norwegian observational study"],"prefix":"10.1136","volume":"11","clinical-trial-number":[{"clinical-trial-number":"nct03904459","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03904459","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5856-4122","authenticated-orcid":false,"given":"Anette","family":"Lundestad","sequence":"first","affiliation":[{"name":"Department of Clinical and Molecular Medicine (IKOM), Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Department of Pediatrics, Trondheim University Hospital St Olav\u2019s Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Cetrelli","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine (IKOM), Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Center for Oral Health Services and Research, TkMidt, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar Welander","family":"Angenete","sequence":"additional","affiliation":[{"name":"Department of Circulation and Medical Imaging (ISB), Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Department of Radiology and Nuclear Medicine, Trondheim University Hospital St Olav\u2019s Hospital, Trondheim, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas Angell","family":"Augdal","sequence":"additional","affiliation":[{"name":"Section of Paediatric Radiology, University Hospital of North Norway, Troms\u00f8, Norway"},{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Tyllesk\u00e4r","sequence":"additional","affiliation":[{"name":"Child and Youth Clinic, Haukeland University Hospital, Bergen, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen Berit","family":"Nordal","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"},{"name":"Department of Pediatrics, University Hospital of North Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Rosendahl","sequence":"additional","affiliation":[{"name":"Section of Paediatric Radiology, University Hospital of North Norway, Troms\u00f8, Norway"},{"name":"Department of Clinical Medicine, UiT The Arctic University of Norway, Troms\u00f8, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gry B\u00f8rmark","family":"Hoftun","sequence":"additional","affiliation":[{"name":"Department of Clinical and Molecular Medicine (IKOM), Norwegian University of Science and Technology, Trondheim, Norway"},{"name":"Department of Pediatrics, Trondheim University 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