Increased serum fibroblast growth factor-23 and decreased bone turnover in patients with systemic lupus erythematosus under treatment with cyclosporine and steroid but not steroid only

Lai, Chih-Sheng; Chen, W.-S.; Chang, Deh‐Ming; Tsao, Yen Po; Wu, Tsai-Hung; Chou, Chung Tei; Tsai, Chang‐Youh

doi:10.1007/s00198-014-2910-3

Cited by 14 publications

(9 citation statements)

References 44 publications

(55 reference statements)

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“…However, BTMs in premenopausal women with SLE have been assessed in only a few cross-sectional studies. 18,19 In the present study, although premenopausal patients with new-onset SLE showed an increase in β-CTX compared with gender-, age- and BMI-matched healthy controls, a decrease in OC and P1NP was observed, indicating an apparent uncoupling of bone remodeling in SLE patients that leads to bone loss and lower BMD.…”

Section: Discussioncontrasting

confidence: 42%

Uncoupled bone remodeling is characteristic of bone damage in premenopausal women with new-onset systemic lupus erythematosus

Zhu

Zhang

Wang

et al. 2021

Lupus

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Objective To investigate the mechanism underlying systemic lupus erythematosus (SLE)-related bone loss by evaluating the bone mineral density (BMD) and bone turnover markers (BTMs) in premenopausal patients with new-onset SLE without any treatment. Methods BMD and BTMs of 106 premenopausal patients with new-onset SLE and 64 gender-, age- and body mass index (BMI)-matched healthy controls were analyzed. BMD was determined using dual energy X-ray absorptiometry (DXA). Serum BTMs were measured. Results Hip and lumbar spine BMD in premenopausal patients with new-onset SLE was significantly decreased compared with healthy controls. Higher rate of osteoporosis was observed in new-onset SLE patients (25% vs. 1%). Moreover, uncoupled bone remodeling evidenced by an increase in bone resorption marker β-CTX (685.9 ± 709.6 pg/mL vs. 395.4 ± 326.0 pg/mL, P < 0.05) and decrease in bone formation markers PINP (37.4 ± 33.0 ng/mL vs. 46.1 ± 20.9 ng/mL, P < 0.05) and OC (11.4 ± 9.8 ng/mL vs. 18.2 ± 8.6 ng/mL, P < 0.05) was observed in premenopausal patients with new-onset SLE compared with healthy controls. Univariate correlation analyses showed negative correlations between OC and SLE Disease Activity Index (SLEDAI), and positive correlations between β-CTX and SLEDAI. SLE patients positive for dsDNA, nucleosome showed lower OC and higher β-CTX. Conclusion Premenopausal patients with new-onset SLE had decreased BMD and abnormal bone metabolism with increased β-CTX and decreased OC and P1NP levels, indicating uncoupled bone remodeling in new-onset SLE patients. Disease activity and abnormal immunity, especially the amount of antibodies in SLE patients, were strongly associated with abnormality of bone metabolism.

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Section: Discussioncontrasting

confidence: 42%

Uncoupled bone remodeling is characteristic of bone damage in premenopausal women with new-onset systemic lupus erythematosus

Zhu

Zhang

Wang

et al. 2021

Lupus

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“…BMD begins to fall from the third month of glucocorticoid use and progresses rapidly to six months. From this period, the curve gradually declines 25 .…”

Section: Systemic Lupus Erythematosus (Sle)mentioning

confidence: 95%

Osteoporosis en enfermedades reumáticas e inducidas por glucocorticoides

Maldonado

Messina

Moreno

et al. 2017

Rev Osteoporos Metab Miner

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Osteoporosis is a systemic skeletal disease characterized by low bone mineral density, changes in bone microarchitecture and increased risk of fracture. It has been shown that depends on physiological processes and secondary to other pathologies and associated with the use of glucocorticoids, the latest being the most common cause of osteoporosis associated to drugs, this may be represent a great magnitude public health issue. This review is presented in order to emphasize the clinical importance of osteoporosis in rheumatic diseases and glucocorticoid-induced osteoporosis.

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“…CSP induces higher bone turnover independent of renal function, decreases osteoblast proliferation, and decreases magnesium stores, important for vitamin D hydroxylation [65]. Recently, systemic lupus patients treated with CSP alone were found to have increases of FGF 23, which correlated with CSP cumulative dose, possibly etiologic in bone loss [66]. It remains debatable whether GVHD itself or its treatment in the form of glucocorticoid or cyclosporine has the greatest impact on bone health.…”

Section: Role Of Glucocorticoids and Calcineurin Inhibitorsmentioning

confidence: 99%

Bone management in hematologic stem cell transplant recipients

et al. 2018

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Autologous and allogeneic hematopoietic stem cell transplantation (HSCT) is the treatment of choice for patients with some malignant and non-malignant hematological diseases. Advances in transplantation techniques and supportive care measures have substantially increased the number of long-term HSCT survivors. This has led to an increasing patient population suffering from the late effects of HSCT, of which, bone loss and its consequent fragility fractures lead to substantial morbidity. Altered bone health, with consequent fragility fractures, and chronic graft-versus-host disease (GVHD) are factors affecting long-term quality of life after HSCT. Hypogonadism, HSCT preparative regimens, nutritional factors, and glucocorticoids all contribute to accelerated bone loss and increased fracture risk. Management strategies should include bone mineral density examination, evaluation of clinical risk factors, and general dietary and physical activity measures. Evidence has accumulated permitting recommendations for more attentiveness to evaluation and monitoring of bone health, with appropriate application of osteoporosis pharmacotherapies to patients at increased risk of bone loss and fracture.

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Increased serum fibroblast growth factor-23 and decreased bone turnover in patients with systemic lupus erythematosus under treatment with cyclosporine and steroid but not steroid only

Abstract: SLE patients treated with glucocorticoid and CsA exhibited markedly decreased bone turnover. Those taking CsA had higher serum FGF-23 associated with suppression of 1,25(OH)2D3 and bone formation. Such high-risk patients necessitate regular screening of osteoporosis.

Cited by 14 publications

References 44 publications

Uncoupled bone remodeling is characteristic of bone damage in premenopausal women with new-onset systemic lupus erythematosus

Uncoupled bone remodeling is characteristic of bone damage in premenopausal women with new-onset systemic lupus erythematosus

Osteoporosis en enfermedades reumáticas e inducidas por glucocorticoides

Bone management in hematologic stem cell transplant recipients

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