scholarly journals Prevalence and Possible Risk Factors of Low Bone Mineral Density in Untreated Female Patients with Systemic Lupus Erythematosus

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Yi-Ning Sun ◽  
Xiu-Yuan Feng ◽  
Lan He ◽  
Ling-Xia Zeng ◽  
Zhi-Ming Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Lupus Erythematosus ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Total Hip ◽  
Female Patients ◽  
Untreated Female

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation. Different studies have shown decreased bone mineral density (BMD) in patients with SLE. The objective of this study was to investigate the prevalence and possible risk factors of low BMD in untreated female patients with SLE in Chinese population. A total of 119 untreated female patients with SLE were included. BMD was measured at lumbar spine and at total hip by dual-energy X-ray absorptiometry. The associations between decreased BMD and demographic variables, clinical variables, and bone metabolism variables were analyzed. These SLE patients had the following characteristics: mean age was32.6±11.9years, mean disease duration was22.1±34.5months, and mean SLEDAI was11.4±5.4. Osteopenia was present in 31.1% of the patients and osteoporosis in 8.5%. A significant negative association between low density lipoprotein cholesterol (LDL-c) and BMD at the lumbar spine (correlation coefficient= −0.242;P=0.023) and total hip (correlation coefficient= −0.259;P=0.019) was shown. These results seem to indicate that increased LDL-c may be an important risk factor for low BMD at lumbar spine and total hip in untreated female SLE patients.

scholarly journals AB0315 DISEASE DAMAGE ACCRUAL AND LOW BONE MINERAL DENSITY IN FEMALE PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1182.3-1183
Author(s):  
M. Correa Rodríguez ◽  
G. Pocovi-Gerardino ◽  
J. L. Callejas-Rubio ◽  
R. Ríos Fernández ◽  
S. Delolmo-Romero ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Disease Activity ◽  
Bone Mineral ◽  
Lupus Erythematosus ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Damage Accrual

Background:Osteoporosis is a common comorbidity in patients with systemic lupus erythematosus (SLE). Available evidence showed that autoimmunity and associated inflammation play main effect in the pathogenesis of negative skeletal effects in SLE patients. However, the potential contribution of disease-associated factors to bone status in SLE is not well known since the reported risk factors from different studies differ greatly.Objectives:The aim of this study was to examine frequency of reduced bone mass in SLE women, and determine their potential associations with disease activity, damage accrual and SLE-related clinical markers.Methods:A cross-sectional study including a total 121 Caucasian pre-menopausal and postmenopausal women was conducted (mean age 49.29±12.43 years). The SLE Disease Activity Index (SLEDAI-2K) and the SDI Damage Index were used to asses disease activity and disease-related damage, respectively. Bone mineral density (BMD) of the left femoral neck and lumbar spine (L2–L4) were measured by dual-energy X-ray absorptiometry (Hologic QDR 400).Results:Ten patients (8.3%) had osteoporosis, 63 (52.1%) patients had osteopenia and 6.8% of women had history of previous fracture. Patients with low bone mass had a significantly higher mean SDI (1.36±1.26 versus 0.70±1.09 p=0.003). T-score at lumbar spine was inversely correlated with SDI score (r=-0.222, p=0.014) and complement C3 level (r=-0.206, p=0.024). Results of bivariate correlations showed that T-score at lumbar spine was inversely correlated with SDI score (r=-0.222, p=0.014) and complement C3 level (r=-0.206, p=0.024). SDI scores were significantly different between patients with osteoporosis, osteopenia and normal BMD after adjusting for age, menstrual status, BMI, time since diagnosis and corticoid use (p=0.004).Conclusion:There is a high prevalence of low BMD in Caucasian women with SLE and this status of osteopenia/osteoporosis was associated with higher damage accrual scores, supporting that disease damage may itself be a major contributor to the low BMD. SLE women with organ damage require regular bone status monitoring to prevent further musculoskeletal damage. Since diminished BMD is a main comorbidity it is therefore essential to study, monitor and prevent osteoporosis in SLE women to avoid fractures leading to reduced quality of life.References:[1]Wang X, Yan S, Liu C, Xu Y, Wan L, Wang Y, et al. Fracture risk and bone mineral density levels in patients with systemic lupus erythematosus: a systematic review and meta-analysis. Osteoporos Int 2016;27:1413–23.[2]Mendoza-Pinto C, Rojas-Villarraga A, Molano-Gonzalez N, Jimenez-Herrera EA, De La Luz Leon-Vazquez M, Montiel-Jarquõn A, et al. Bone mineral density and vertebral fractures in patients with systemic lupus erythematosus: A systematic review and meta-regression. PLoS One 2018;13:1–15.[3]Xia J, Luo R, Guo S, Yang Y, Ge S, Xu G, et al. Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis. Biomed Res Int 2019;2019.[4]Carli L, Tani C, Spera V, Vagelli R, Vagnani S, Mazzantini M, et al. Risk factors for osteoporosis and fragility fractures in patients with systemic lupus erythematosus. Lupus Sci Med 2016;3:1–5.Acknowledgements:This research was supported by the grant PI0523-2016 from “Consejería de igualdad, salud y políticas sociales” (Junta de Andalucía) and is part of the research group LyDIMED “Lupus y Dieta Mediterránea”.Disclosure of Interests:None declared

Bone Mineral Density Change in Systemic Lupus Erythematosus: A 5-year Followup Study

2014 ◽  
Vol 41 (10) ◽  
pp. 1990-1997 ◽  
Author(s):  
Tracy Y. Zhu ◽  
James F. Griffith ◽  
Sze-Ki Au ◽  
Xiao-Lin Tang ◽  
Anthony W. Kwok ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Lupus Erythematosus ◽  
Organ Damage ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Total Hip

Objective.To determine changes of bone mineral density (BMD) over a 5-year period in a cohort of female patients with systemic lupus erythematosus (SLE) and to identify factors predictive of BMD loss.Methods.Our longitudinal study involved 125 female patients with SLE with a mean (SD) age of 46.5 years (10.1) and a median disease duration of 10.4 years. Demographics and clinical data were collected and BMD at the femoral neck, total hip, and lumbar spine (L1-4) was performed by using dual-energy x-ray absorptiometry at baseline and followup.Results.Average percentage changes of BMD over a mean followup of 5 years were −2.41% at the femoral neck, −1.63% at the total hip, and −0.62% at the lumbar spine, with significant changes at both the femoral neck (p < 0.0001) and total hip (p < 0.0005), but not at the lumbar spine (p = 0.128). Disease flare, new organ damage, and use of glucocorticoids during followup were significantly associated with larger decreases in BMD. BMD loss was arrested at the femoral neck and BMD increased at the total hip and lumbar spine in patients receiving antiosteoporosis therapy. In multivariate analyses, use of antiosteoporosis therapy was independently associated with increased BMD at any site and new organ damage was an independent predictor of BMD loss at the femoral neck.Conclusion.Significant BMD loss at the hip over a period of 5 years was found in patients with SLE. Disease activity, disease damage, and use of glucocorticoids are the disease-specific variables that contribute to bone loss in SLE.

Disease Damage Accrual and Low Bone Mineral Density in Female Patients with Systemic Lupus Erythematosus

2021 ◽  
pp. 109980042110055
Author(s):  
María Correa-Rodríguez ◽  
Gabriela Pocovi-Gerardino ◽  
José-Luis Callejas-Rubio ◽  
Raquel Ríos-Fernández ◽  
Blanca Rueda-Medina ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Bone Mass ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Damage Accrual ◽  
Disease Damage

Osteoporosis is a common comorbidity in patients with systemic lupus erythematosus (SLE), but the potential contribution of disease-associated factors to bone status in SLE is not well known because the reported risk factors from different studies differ greatly. We aimed to examine frequency of reduced bone mass in women with SLE, and determine their potential associations with disease activity, damage accrual and SLE-related clinical markers. A cross-sectional study including 121 Caucasian pre-menopausal and postmenopausal women was conducted (mean age 49.2 ± 12.4 years). The SLE Disease Activity Index (SLEDAI-2 K) and the SDI Damage Index were used to assess disease activity and disease-related damage, respectively. Bone mineral density (BMD) of the left femoral neck and lumbar spine (L2–L4) were measured by dual-energy X-ray absorptiometry. Ten patients (8.3%) had osteoporosis, 63 (52.1%) patients had osteopenia and 6.8% of women had history of previous fracture. Patients with low bone mass had a significantly higher mean SDI (1.3 ± 1.2 versus 0.7 ± 1.0 p = 0.003). T-score at lumbar spine was inversely correlated with SDI score (r = -0.222, p = 0.014) and complement C3 level ( r = −0.206, p = .024). SDI scores were significantly different between patients with osteoporosis, osteopenia, and normal BMD after adjusting for covariates ( p = .004). There is a high prevalence of low BMD in Caucasian women with SLE, and this status was associated with higher damage accrual scores, supporting that disease damage may itself be a major contributor to the low BMD. Women with SLE with organ damage require regular bone status monitoring to prevent further musculoskeletal damage.

scholarly journals SAT0484 TRABECULAR BONE SCORE IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1198.2-1198
Author(s):  
A. Casabella ◽  
S. Paolino ◽  
E. Alessandri ◽  
V. Smith ◽  
B. Ruaro ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Trabecular Bone ◽  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Trabecular Bone Score ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Research Support

Background:Systemic lupus erythematosus (SLE) patients shown an increased risk of low bone mass as a result of multifactorial events: physical inactivity, persistent inflammation, low vitamin D levels (photosensitivity) and glucocorticoid treatment. Trabecular Bone Score (TBS), is an index extracted from the dual-energy X-ray absorptiometry (DXA) that provides an indirect measurement of bone axial microarchitecture and allows to get information about bone quality in several rheumatic diseases (1-4).Objectives:The aims of this study were to examine the prevalence and risk factors for low bone mineral density (BMD) (osteoporosis or osteopenia) in female patients affected by SLE and to compare with matched healthy subjects (CNT).Methods:70 female patients (mean age 41±20 years) affected by SLE and 65 age- matched CNT (mean age 46±7 years) were enrolled. Bone Mineral Density (BMD, g/cm2) of the lumbar spine (L1-L4) was analyzed using a DXA scan (GE, Lunar Prodigy). Lumbar spine TBS was derived for each spine DXA examination using the TBS index (TBS iNsight Medimaps).Results:The mean BMD±SD was 0.47±0.57 g/cm2 at the lumbar spine and 0.78 ± 0.22 g/cm2 at the hip in SLE patients. The prevalence of osteopenia was 40.0% and was 19.4% of osteoporosis in SLE patients. Most of SLE patients (75%) presented a bone loss that was significantly higher when compared with control group (p<0.001). Lumbar spine TBS score was found significantly lower in SLE patients compared with CNT (0.687±0.675 vs, 1.294±0.809 p<0.001, respectively) and of 0,47±0,94 times lower than expected from the concomitant reference BMD value.Conclusion:The study shows that the further TBS analysis, independently from the concomitant BMD value, is significatively lower then expected in SLE patients. The detection of the TBS, together with the BMD, may offer a more reliable indication of the real whole bone condition in chronic and systemic inflammatory rheumatic diseases, such as SLE.References:[1]Cutolo M et al. Ann Rheum Dis. 2009;68 446-7; 2 Dey M et al. Lupus. 018;271547-1551; 3 Ruaro B, Casabella A, et al. Rheumatology (Oxford). 2018;57:1548-1554. 4 Ruaro B, Casabella A, et al. Clin Rheumatol. 2018 Nov;37(11):3057-3062.Disclosure of Interests:Andrea Casabella: None declared, Sabrina Paolino: None declared, Elisa Alessandri: None declared, Vanessa Smith Grant/research support from: The affiliated company received grants from Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer Ingelheim Pharma GmbH & Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH & Co, Speakers bureau: Actelion Pharmaceuticals Ltd, Boehringer-Ingelheim Pharma GmbH & Co and UCB Biopharma Sprl, Barbara Ruaro: None declared, Carmen Pizzorni: None declared, Alberto Sulli Grant/research support from: Laboratori Baldacci, Maurizio Cutolo Grant/research support from: Bristol-Myers Squibb, Actelion, Celgene, Consultant of: Bristol-Myers Squibb, Speakers bureau: Sigma-Alpha

A Comparison of Calcium, Calcitriol, and Alendronate in Corticosteroid-Treated Premenopausal Patients with Systemic Lupus Erythematosus

2008 ◽  
Vol 35 (12) ◽  
pp. 2344-2347 ◽  
Author(s):  
SWAN S. YEAP ◽  
AHMAD R. FAUZI ◽  
NORELLA C.T. KONG ◽  
ABDUL G. HALIM ◽  
ZAINUDIN SOEHARDY ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lumbar Spine ◽  
Calcium Carbonate ◽  
Lupus Erythematosus ◽  
Premenopausal Women ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Total Hip ◽  
Hip Bmd ◽  
Premenopausal Patients

ObjectiveTo assess bone mineral density (BMD) changes in patients with systemic lupus erythematosus (SLE) undergoing longterm therapy with corticosteroids (CS) while taking calcium, calcitriol, or alendronate. The primary endpoint was BMD changes at 2 years.MethodsPremenopausal SLE patients were randomized into 3 groups according to medication: calcium carbonate 500 mg bd (calcium alone), calcitriol 0.25 μg bd plus calcium carbonate 500 mg bd (calcitriol + calcium), and alendronate 70 mg/week plus calcium carbonate 500 mg bd (alendronate + calcium). BMD was measured at baseline and at the end of the first and second years.ResultsNinety-eight patients were recruited. There were 33 patients taking calcium alone, 33 calcitriol + calcium, and 32 alendronate + calcium. On randomization, median duration of CS use was 2.5 years (range 0–20 yrs). Seventy-seven patients (78.6%) completed the study (23 taking calcium alone, 27 calcitriol + calcium, 27 alendronate + calcium). There were no significant differences in mean CS dosages among the 3 groups at the time of BMD measurements. After 2 years, there were no significant changes in BMD in the calcium-alone and calcitriol + calcium groups, apart from a 0.93% (p < 0.001) reduction in total hip BMD in the calcium-alone group. In contrast, the alendronate + calcium group showed significant increases in BMD of 2.69% (p < 0.001) in the lumbar spine and 1.41% (p < 0.001) in total hip.ConclusionBoth calcium alone and calcitriol + calcium preserved lumbar spine BMD in premenopausal patients with SLE taking longterm CS at 2 years, whereas alendronate + calcium led to increases in BMD in lumbar spine and total hip. Premenopausal women taking CS should be considered for osteoporosis prophylaxis.

scholarly journals Prevalence of and risk factors for low bone mineral density and vertebral fractures in patients with systemic lupus erythematosus

2005 ◽  
Vol 52 (7) ◽  
pp. 2044-2050 ◽  
Author(s):  
Irene E. M. Bultink ◽  
Willem F. Lems ◽  
Piet J. Kostense ◽  
Ben A. C. Dijkmans ◽  
Alexandre E. Voskuyl
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Lupus Erythematosus ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Low Bone Mineral Density
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