Bone Mineral Density in Women with Systemic Lupus Erythematosus

Bhattoa, Harjit Pal; Bettembuk, P.; Balogh, Á.; Szegedi, Gyula; Kiss, Emese

doi:10.1007/s10067-002-8272-9

Cited by 34 publications

(28 citation statements)

References 42 publications

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“…Although we found that many surrogate measures of disease severity, including use of immunosuppressive agents and disease damage score (as measured by SDI), were significantly associated with BMD by univariate analysis, none of these measures was significantly associated with BMD by multivariate analysis. Our finding of a lack of association with measures of disease damage in multivariate analysis contrasts with the results of studies in adult SLE (30,(32)(33)(34)36). Our results suggest that factors other than disease damage or severity may be more important in determining BMD in juvenile SLE.…”

Section: Discussioncontrasting

confidence: 97%

“…These findings are similar to those in previous investigations of adult SLE (29)(30)(31)(32)(33)(34)(35)(36)(37). We suggest that, pending future studies examining the association of fracture risk and BMD in pediatric patients, the definitions of osteopenia and osteoporosis used in adults, i.e., Ϫ1 and Ϫ2.5, respectively, should be used.…”

Section: Discussionsupporting

confidence: 87%

“…Consistent with our findings are the results of studies in adult premenopausal patients with SLE, in which decreased BMD was not found to be correlated with corticosteroid use, total corticosteroid dose, or duration of corticosteroid use (29)(30)(31)(32)(33)(34)(35)(36)(37). Investigations of pediatric patients with nephrotic syndrome have yielded conflicting results regarding the role of corticosteroids in the development of osteoporosis (38,39).…”

Section: Discussionsupporting

confidence: 85%

“…Studies in adults with SLE have suggested that the decreased BMD is related to disease damage and disease duration, rather than to measures of disease activity or severity (30,(32)(33)(34)36). In the present study, univariate analysis showed multiple measures of disease activity, specific disease manifestations, and therapies to be associated with the 3 measures of abnormally low BMD.…”

Section: Discussionsupporting

confidence: 47%

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Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus

Compeyrot-Lacassagne¹,

Tyrrell²,

Atenafu³

et al. 2007

Arthritis & Rheumatism

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Objective. Studies of adults with systemic lupus erythematosus (SLE) have frequently demonstrated the presence of decreased bone mineral density (BMD).However, there have been few investigations in pediatric patients to date. This study was undertaken to determine the prevalence of low BMD in patients with juvenile SLE and to identify associated risk factors.Methods. We studied 64 consecutive patients with juvenile SLE in whom routine dual x-ray absorptiometry (DXA) scanning was performed. Lumbar spine osteopenia was defined as a BMD Z score of <؊1 and >؊2.5, and osteoporosis as a BMD Z score of <؊2.5. Decreased hip BMD was defined as a value of <80%. Data on disease activity, quality of life, disease-related damage, sex, ethnicity, body mass index, age at diagnosis, age at DXA, medication use and duration, clinical features, and puberty status were collected at the time of DXA.Results. Lumbar spine osteopenia was seen in 24 patients (37.5%) and osteoporosis in 13 (20.3%). Decreased hip BMD was present in 12 patients (18.8%). By univariate analysis, osteopenia was significantly correlated with age, disease duration, duration of corticosteroid use, cumulative corticosteroid dose, azathioprine use, cyclophosphamide use, lupus nephritis, and damage. Two additional variables, mycophenolate mofetil use and class III-IV nephritis, were associated with osteoporosis. Abnormal hip BMD was associated with disease duration, duration of corticosteroid use, and cumulative corticosteroid dose. By multivariate analysis, only disease duration remained in the model for osteoporosis and abnormal hip BMD, while cumulative corticosteroid dose was the variable associated with osteopenia.Conclusion. These results indicate that osteopenia and osteoporosis are common in juvenile SLE and are associated more closely with increased disease duration than with cumulative corticosteroid dose.

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Section: Discussioncontrasting

confidence: 97%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 47%

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Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus

Compeyrot-Lacassagne¹,

Tyrrell²,

Atenafu³

et al. 2007

Arthritis & Rheumatism

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“…Also, they decrease intestinal calcium absorption, increase urinary calcium excretion, and disturb vitamin D metabolism. [6] Some studies [7][8][9][10][11][12] have addressed the problem of low BMD in patients with SLE. Osteoporosis occurs in up to 24% of patients at the lumbar spine and 23% at the femoral hip.…”

mentioning

confidence: 99%

Efficacy of Weight Bearing Exercises for Systemic Lupus Erythematosus Patients Suffered From Osteoporosis

Waked¹

2017

IJPR

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Objective: the aim of this study was to evaluate the efficacy of weight bearing exercises for systemic lupus erythematosus patients suffered from osteoporosis Methods: Forty patients were randomly divided into two groups of equal number. Exercise group (E) received weight-bearing exercises and the control group (C) didn't receive any type of exercise. Bone mineral density was measured by Dual X-ray absorptiometry at the beginning of the study and after 2 months for all patients. Results:The results showed that there were significant positive changes in bone mineral density in exercise group while there was a decrease in Bone mineral density in control group.Conclusion: It could be concluded that weight bearing exercises program have a significant improvement effect in bone mineral density in systemic lupus erythematosus patients suffered from osteoporosis.

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

Bultink¹,

Lems²,

Kostense³

et al. 2005

Arthritis & Rheumatism

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200

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Objective. To examine the prevalence of and risk factors for low bone mineral density (BMD) and vertebral fractures in patients with systemic lupus erythematosus (SLE).Methods. We studied 107 SLE patients. Demographic and clinical data were collected, and radiographs of the thoracic and lumbar spine and BMD measurements by dual x-ray absorptiometry were performed. Vertebral deformities were scored according to the method of Genant et al: fractures were defined as a reduction of >20% of the vertebral body height. Osteoporosis was defined as a T score less than -2.5 SD and osteopenia as a T score less than -1.0 SD in at least 1 region of measurement.Results. Osteopenia was present in 39% of the patients and osteoporosis in 4% (93% female; mean age 41.1 years). In multiple regression analysis, low BMD in the spine was associated with a low body mass index (BMI), postmenopausal status, and 25-hydroxyvitamin D deficiency. Low BMD in the hip was associated with low BMI and postmenopausal status. At least 1 vertebral fracture was detected in 20% of the patients. Vertebral fractures were associated with ever use of intravenous methylprednisolone and male sex.Conclusion. Risk factors for low BMD in SLE patients are low BMI, postmenopausal status, and vitamin D deficiency. While osteoporosis defined as a low T score was found in only 4% of the patients, osteoporotic vertebral fractures were detected in 20%. The high prevalence of low BMD and vertebral fractures implies that more attention must be paid to the prevention and treatment of osteoporosis and fractures in SLE.Over the last few decades, the survival of patients with systemic lupus erythematosus (SLE) has improved dramatically (1), and the morbidity pattern has shown a shift toward long-term complications, including osteoporosis. Several studies have demonstrated a high prevalence of low bone mineral density (BMD) in patients with SLE, especially female patients. For example, osteopenia is reported in 25-46% of SLE patients (2-4) and osteoporosis, defined as a T score less than -2.5 SD, is reported in 1-23% (5-7).In contrast, little attention is paid to osteoporotic fractures, one of the items of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index for SLE (8). Studies on fractures in SLE have focused on incident cases of symptomatic vertebral and nonvertebral fractures (2,3,9,10) or on prevalent vertebral deformities, i.e., fractures (11)(12)(13)(14)(15)(16)(17). However, the method used to assess vertebral fractures in 6 of these studies (11,(13)(14)(15)(16)(17) is not clear, and vertebral fractures were scored using dual x-ray absorptiometry (DXA) images in 1 study (12). Moreover, in the majority of these studies, only a limited number of patients were evaluated (11,12,(14)(15)(16)(17).The importance of identifying prevalent vertebral fractures in SLE patients is illustrated by the observed association between prevalent vertebral deformities and reduced quality of life in postmenopausal women with oste...

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Bone Mineral Density in Women with Systemic Lupus Erythematosus

Cited by 34 publications

References 42 publications

Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus

Prevalence and etiology of low bone mineral density in juvenile systemic lupus erythematosus

Efficacy of Weight Bearing Exercises for Systemic Lupus Erythematosus Patients Suffered From Osteoporosis

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

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