OBJECTIVE: To establish the prevalence of reduced bone mineral density (BMD) and fractures, and risk factors for fractures, in a cross sectional study of a large cohort of patients with systemic lupus erythematosus (SLE). METHODS: All SLE patients willing to take part in the study had bone densitometry in 1999/2000 and completed a questionnaire on risk factors for osteoporosis and on drugs used. Accumulated damage was scored using the SLICC/ACR damage index (SDI). Only fractures occurring since the onset of SLE and unrelated to trauma were included, and the SDI score was modified to exclude osteoporotic fractures. Statistical analysis was by chi(2) test, Fisher's exact test, and binary logistic regression. RESULTS: 242 patients were studied, median age 39.9 years (range 18 to 80), median disease duration 7.0 years (range 0 to 42). Of these, 123 (50.8%) had reduced BMD (T score <-1.0) and 25 (10.3%) were in the osteoporotic range (T score <-2.5). Fragility fractures had occurred in 22 patients (9.1%) since diagnosis of SLE. Of these, two (9.1%) had normal BMD and 20 (90.9%) had reduced BMD, while seven (31.8%) were within the osteoporotic range. Non-Afro-Caribbean race and exposure to prednisolone >10 mg daily were significantly associated with reduced BMD, while age and menopause were associated with osteoporosis. The risk factors for fractures were reduced BMD and age. CONCLUSIONS: Reduced BMD, osteoporosis, and fragility fractures appear to be prevalent in patients with SLE. Steroids were not an independent risk factor for fractures, although their effect could be mediated through reduced bone mineral density.
OBJECTIVE: To establish the prevalence of reduced bone mineral density (BMD) and fractures, and risk factors for fractures, in a cross sectional study of a large cohort of patients with systemic lupus erythematosus (SLE). METHODS: All SLEpatients willing to take part in the study had bone densitometry in 1999/2000 and completed a questionnaire on risk factors for osteoporosis and on drugs used. Accumulated damage was scored using the SLICC/ACR damage index (SDI). Only fractures occurring since the onset of SLE and unrelated to trauma were included, and the SDI score was modified to exclude osteoporotic fractures. Statistical analysis was by chi(2) test, Fisher's exact test, and binary logistic regression. RESULTS: 242 patients were studied, median age 39.9 years (range 18 to 80), median disease duration 7.0 years (range 0 to 42). Of these, 123 (50.8%) had reduced BMD (T score <-1.0) and 25 (10.3%) were in the osteoporotic range (T score <-2.5). Fragility fractures had occurred in 22 patients (9.1%) since diagnosis of SLE. Of these, two (9.1%) had normal BMD and 20 (90.9%) had reduced BMD, while seven (31.8%) were within the osteoporotic range. Non-Afro-Caribbean race and exposure to prednisolone >10 mg daily were significantly associated with reduced BMD, while age and menopause were associated with osteoporosis. The risk factors for fractures were reduced BMD and age. CONCLUSIONS: Reduced BMD, osteoporosis, and fragility fractures appear to be prevalent in patients with SLE. Steroids were not an independent risk factor for fractures, although their effect could be mediated through reduced bone mineral density.
Authors: V B Dhillon; M C Davies; M L Hall; J M Round; P J Ell; H S Jacobs; M L Snaith; D A Isenberg Journal: Ann Rheum Dis Date: 1990-08 Impact factor: 19.103
Authors: E M Tan; A S Cohen; J F Fries; A T Masi; D J McShane; N F Rothfield; J G Schaller; N Talal; R J Winchester Journal: Arthritis Rheum Date: 1982-11
Authors: L J Melton III; M A Marquez; S J Achenbach; A Tefferi; M K O'Connor; W M O'Fallon; B L Riggs Journal: Osteoporos Int Date: 2002-07 Impact factor: 4.507
Authors: J D Adachi; W G Bensen; J Brown; D Hanley; A Hodsman; R Josse; D L Kendler; B Lentle; W Olszynski; L G Ste-Marie; A Tenenhouse; A A Chines Journal: N Engl J Med Date: 1997-08-07 Impact factor: 91.245
Authors: Shinya Ishii; Jane A Cauley; Gail A Greendale; Carolyn J Crandall; Michelle E Danielson; Yasuyoshi Ouchi; Arun S Karlamangla Journal: J Bone Miner Res Date: 2013-07 Impact factor: 6.741
Authors: Katarina Almehed; Szabolcs Hetényi; Claes Ohlsson; Hans Carlsten; Helena Forsblad-d'Elia Journal: Arthritis Res Ther Date: 2010-08-02 Impact factor: 5.156