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Bone Mineral Density in Premenopausal Women with Systemic Lupus Erythematosus
SOMCHAI UARATANAWONG, UTIS DEESOMCHOKE, SOMRAT LERTMAHARIT, and SOMSRI UARATANAWONG
ABSTRACT.
Methods. A cross-sectional study on BMD of 118 premenopausal women with SLE. Patients were divided into 2 groups, 74 who had been treated with corticosteroids and 44 who had not. BMD at lumbar spine, femoral neck, and trochanter was measured. Results. BMD in patients without and with corticosteroid treatment was 1.13 ± 0.13 vs 1.05 ± 0.14 g/cm2 (p = 0.005) at lumbar spine, 0.92 ± 0.12 vs 0.86 ± 0.12 g/cm2 (p = 0.005) at femoral neck, and 0.78 ± 0.13 vs 0.72 ± 0.12 g/cm2 (p = 0.014) at trochanter, respectively. Stepwise multilinear regression analysis showed that corticosteroid exposure was independently associated with decreased BMD in the corticosteroid treated patients (r2 = 7% for lumbar and 6.6% for trochanter model). No significant difference in BMD in corticosteroid treated patients appeared when they were subgrouped according to whether they were taking calcium supplements. Prevalence of osteoporosis at lumbar spine in corticosteroid treated patients was 1.4%, and was lower than reported for age and sex matched Caucasians. Conclusion. BMD measurements were significantly lower in premenopausal SLE patients who had had corticosteroid treatment than those who had not. There was a negative correlation between BMD and corticosteroid therapy, but not disease activity. Prevalence of osteoporosis, based on lumbar spine BMD, was lower than that reported in Caucasians. (J Rheumatol 2003;30:2365-8) Key Indexing Terms:
BONE MINERAL DENSITY
From the Rheumatology Unit, Department of Medicine, Bangkok Metropolitan Medical College and Vajira Hospital, Bangkok, Thailand. S. Uaratanawong, MD, Rheumatology Unit, Department of Medicine, Bangkok Metropolitan Administration Medical College and Vajira Hospital; U. Deesomchoke, Professor, Rheumatology Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University; S. Lertmaharit, Assistant Professor, Department of Preventive and Social Medicine, Chulalongkorn University; S. Uaratanawong, BSc, Division of Nuclear Medicine, Department of Radiology, Bangkok Metropolitan Administration Medical College and Vajira Hospital. Address reprint requests to Dr. S. Uaratanawong, Rheumatology Unit, Department of Medicine, Bangkok Metropolitan Administration Medical College and Vajira Hospital, 681 Samsen Road, Dusit, Bangkok 10300, Thailand. Submitted June 20, 2001; revision accepted April 17, 2003. |