Evidence map›Paper›PMID 33644265›Full record

ArticleBone reports2021

Bone mass and vertebral fractures in South African children on prolonged oral glucocorticoids for chronic non-malignant illnesses.

Kebashni Thandrayen, Udai Keshav Kala, Nilesh Lala, Grace Okudo, Kiran Bhagoo Parbhoo, Fatima Yakoub Moosa, Charl Verwey, Marc Hauptfleisch, Christina Hajinicolaou, Priya Ramanlal Ambaram and 3 more

Open access · goldAbstract read
In one paragraph

Article in Bone reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 98% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 1 citations in OpenAlex.

  1. Exploring the natural history of bone mineral density in Duchenne muscular dystrophy: a systematic literature review.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025
    Pooled it
  2. Vertebral fractures and muscle function in glucocorticoid-treated individuals with Duchenne muscular dystrophy: a cohort study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Kebashni ThandrayenDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Udai Keshav KalaDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Nilesh LalaDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Grace OkudoDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Kiran Bhagoo ParbhooDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Fatima Yakoub MoosaDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Charl VerweyDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Marc HauptfleischDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Christina HajinicolaouDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Priya Ramanlal AmbaramDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Bhadrish Jayantkumar MistryDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
Karen Lavinia PetersenDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
John Morley PettiforDepartment of Paediatrics, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
University of the Witwatersrand · ZAChris Hani Baragwanath Hospital · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe hypothesized that the prevalence of vertebral fractures would be low and that bone mineral density (BMD) would be less severely affected in a black South African (SA) population treated with glucocorticoids (GCs) than that reported in mainly white populations.

methodsAll children aged 5-17.9 years with chronic non-malignant illnesses who were on GCs (intravenous or oral) for greater than 3 months duration were evaluated. DXA scans were performed using a Hologic Discovery machine (Software version Apex 4.0.2) and the Hologic paediatric reference database. Whole body less head (WBLH) and lumbar spine (LS) bone mineral content (BMC) and density (BMD) Z-scores unadjusted and adjusted for height were calculated using the Zemel equation calculator.

resultsSeventy-two patients (49% with renal, 24% with rheumatic, 14% with neurological, 11% with hepatic and 3% with respiratory conditions; mean age 11.6 ± 3.3 years, 57% boys, 92% SA black) were enrolled. The mean duration of GC treatment was 34.1 (±25.1) months. Mean WBLH and LS height adjusted BMD Z-scores were -1.2 ± 1.5 and -0.9 ± 1.0 respectively. Eleven percent of patients had a LS height adjusted BMD Z-score ≤ -2. The prevalence of vertebral fractures on lateral vertebral fracture assessment (VFA) was 15% (11 of 72 patients).

conclusionThe prevalence of vertebral fractures (15%) in predominantly black children on GCs with chronic non-malignant illnesses is similar to that reported from North America suggesting that routine yearly DXA scans including VFA are warranted in this highly at-risk population.

Indexed as

Bone mineral densityChildrenFracturesGlucocorticoidsOsteoporosisSouth Africa

Identifiers

PMID33644265
PMCPMC7887385
OpenAlexW3126473031

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.