Loss of trabecular bone mineral density in systemic lupus erythematosus

Abstract

Objective. To evaluate trabecular bone mineral density (BMD) in young ambulatory female patients with systemic lupus erythematosus (SLE).Methods. Bone mineral density (gm/cm2) at the lumbar vertebrae (Ll-L4) and at the left femur (neck, trochanter, intertrochanter, and Ward's triangle) was measured by dual x-ray absorptiometry in 46 SLE patients (mean age 31 years, mean disease duration 76 months) and in 108 healthy female controls (mean age 32 years). Twenty-two of the SLE patients were receiving corticosteroids (CS) at the time of the study.Results. Lumbar BMD in the SLE patients was less severely reduced than was BMD at the femoral sites, but the SLE group was closer to the lumbar fracture threshold of 0.812 gm/cm2 than was the control group (P = 0.0009). There were no significant differences between the SLE patients currently being treated with corticosteroids and those who were not (P > 0.3). BMD at Ward's triangle and at the femoral neck was not significantly reduced in the SLE patients. Total femoral BMD had a sensitivity of 76% and specificity of 62% in differentiating the SLE group from the controls. The

Osteoporosis and fractures in systemic lupus erythematosus

“…Osteopenia is reported in 25-74% (1,2) and osteoporosis is reported in 1.4 -68% (3,4) of SLE patients. These frequencies differ widely as a consequence of differences in size, age, sex, ethnicity, disease severity, and medication use between the patient groups investigated.…”

“…tion, and by the development of low 1,25-dihydroxyvitamin D (1,25[OH] 2 D) serum levels, which might impair intestinal calcium absorption. However, an association between impaired renal function and low BMD was reported in only 1 study, in older female lupus patients (5).…”

Bone mineral density of Brazilian girls with juvenile dermatomyositis

“…It used to be primarily an agerelated disorder occurring in postmenopausal women and in the elderly, but more recently it has been observed to be associated with diseases such as asthma, rheumatoid arthritis, dermatomyositis, and systemic lupus erythematosus (SLE) (2)(3)(4)(5)(6). Previous studies have assessed multiple factors as possible contributors to the reduction in bone mineral density (BMD) in patients with these diseases.…”

Doença óssea em pacientes com nefrite lúpica: aspectos inflamatórios

“…A influência da atividade inflamatória per se sobre o status ósseo dos pacientes lúpicos começou a ganhar destaque na literatura mediante a publicação de alguns estudos que não demonstraram associação entre redução da DMO e uso de corticóide (9,12,13,(60)(61)(62)  Resposta Parcial: estabilização (± 25% do valor basal) ou melhora da creatinina associado a uma redução ≥ 50% da proteinúria em relação ao valor basal. Em casos de proteinúria basal em níveis nefróticos, a redução ≥ 50% da proteinúria em relação ao valor basal deve ser associada a níveis < 3g/24 horas.…”

“…Além disso, a maior parte dos estudos disponíveis são baseados na avaliação densidade mineral óssea (DMO) através da densitometria, um método de custo relativamente baixo e amplamente disponível (12)(13)(14)(15)(16)(17)(18). Entretanto, sabemos que a redução da DMO, apesar de clinicamente relevante, pode não refletir adequamente a resistência óssea e, principalmente, não contribui para a compreensão da fisiopatologia da doença óssea (19,20).…”