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 ◽  
...  

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.

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Yi-Ning Sun ◽  
Xiu-Yuan Feng ◽  
Lan He ◽  
Ling-Xia Zeng ◽  
Zhi-Ming Hao ◽  
...  

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.


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 ◽  
...  

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


Lupus ◽  
2016 ◽  
Vol 26 (3) ◽  
pp. 289-293 ◽  
Author(s):  
Qinyue Guo ◽  
Ping Fan ◽  
Jing Luo ◽  
Shufang Wu ◽  
Hongzhi Sun ◽  
...  

Objective Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease. However, the exact mechanism underlying SLE-related osteopenia and osteoporosis in patients newly diagnosed with SLE remains unknown. Methods 60 male subjects with SLE aged 20–30 years were enrolled. Serum osteocalcin was examined as a marker of bone formation and type I collagen degradation products (β-crosslaps) as markers of bone resorption. Lumbar spine (L1-L4) and total hip bone mineral density (BMD) were determined by dual energy X-ray absorption (DXA). Results Among the 60 subjects with SLE at the time of diagnosis, the cohort showed a significant reduction of osteocalcin (12.62 ± 2.16 ng/mL), and serum β-crosslaps level (992.6 ± 162.6 pg/mL) was markedly elevated. Univariate correlation analyses revealed negative correlations between osteocalcin and SLEDAI, dsDNA antibody and β-crosslaps. A positive correlation was also observed between osteocalcin and C3, C4, 25-OH vitamin D, BMD L1–L4 and BMD total hip (see Table 3). Osteocalcin and β-crosslaps were strongly associated with SLE disease activity by multiple stepwise logistic regression analysis. Conclusion Osteocalcin was negatively associated with SLE disease activity, and β-crosslaps was positively associated with SLE disease activity, suggesting SLE disease activity itself directly contributed to the development of SLE-associated osteopenia and osteoporosis.


2021 ◽  
pp. 109980042110055
Author(s):  
María Correa-Rodríguez ◽  
Gabriela Pocovi-Gerardino ◽  
José-Luis Callejas-Rubio ◽  
Raquel Ríos-Fernández ◽  
Blanca Rueda-Medina ◽  
...  

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.


2011 ◽  
Vol 9 (S1) ◽  
Author(s):  
Ana Paula Roenick Guenka ◽  
Blanca Bica ◽  
Laura Mendonça ◽  
Lucas Velloso ◽  
Mario Leitão

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