J Rheum Dis.  2011 Mar;18(1):19-25. 10.4078/jrd.2011.18.1.19.

Risk Factors for Low Bone Mineral Density in Korean Patients with Systemic Lupus Erythematosus

Affiliations
  • 1Division of Rheumatology, Department of Internal Medicine, The Catholic University of Korea, Suwon, Korea. wan725@catholic.ac.kr

Abstract


OBJECTIVE
To determine the degree and risk factors for decreased bone mineral density (BMD) in patients with systemic lupus erythematosus (SLE).
METHODS
One hundred and one patients with SLE and 57 age- and gender- matched healthy controls were enrolled in this study. The BMD was measured by dual energy X-ray absorptiometry (DXA). The laboratory findings and clinical variables evaluated in the SLE patients consisted of disease duration, SLE disease activity index (SLEDAI), and medications, including mean and cumulative dose of glucocorticoid. At the time of the clinical and laboratory assessment, the levels of serum osteocalcin, serum FSH/LH, urine deoxypyridinoline (DPD), and serum cytokines, such as IL-6 and soluble receptor activator of NF-kB ligand (RANKL), were determined in SLE patients using a enzyme-linked immunosorbent assay.
RESULTS
The BMD T score decreased in patients with SLE compared to the healthy controls (-1.11 versus -0.41, p=0.001 at lumbar spine, -0.84 versus -0.01, p<0.001 at femur neck, -1.20 versus -0.45, p<0.001 at total hip, respectively). Osteoporosis and osteopenia was present in 16.8% and 46.5% of patients, respectively. Multiple regression analysis revealed a low BMD in the lumbar spine to be associated with increased FSH, low BMI and cumulative glucocorticoid dose. A low BMD in the hip and femur neck was associated with increased FSH, low BMI, and duration of glucocorticoid. On the other hand, the levels of osteocalcin, deoxypyridinoline (DPD), IL-6, and soluble RANKL were similar in patients with a low BMD and those with normal BMD.
CONCLUSION
Osteoporosis and osteopenia are more common in young Korean SLE patients than in control subjects. Elevated FSH, low BMI, and the use of glucocorticoid are independent risk factors linked to a decreased BMD in Korean patients with SLE.

Keyword

Systemic lupus erythematosus; Bone mineral density; FSH; BMI; Glucocorticoi

MeSH Terms

Absorptiometry, Photon
Amino Acids
Bone Density
Bone Diseases, Metabolic
Cytokines
Femur Neck
Hand
Hip
Humans
Interleukin-6
Lupus Erythematosus, Systemic
NF-kappa B
Osteocalcin
Osteoporosis
Risk Factors
Spine
Amino Acids
Cytokines
Interleukin-6
NF-kappa B
Osteocalcin

Figure

  • Figure 1. Bone mineral density at different sites in the patients with SLE and age-and gender-matched healthy controls. The BMD T-score was significantly lower in the SLE patients than in the healthy controls (−1.11±0.13 versus −0.41±0.15, p=0.001 at lumbar spine, −0.84±0.11 versus −0.01±0.15, p<0.001 at femur neck, −1.20±0.11 vs −0.45±0.14, p<0.001 at total hip, respectively). The data is reported as the mean± SEM.


Cited by  1 articles

The Present and Future of Clinical Research for Korean Lupus Patients
Dam Kim, Soo-Kyung Cho, Yoon-Kyoung Sung
J Rheum Dis. 2014;21(2):54-63.    doi: 10.4078/jrd.2014.21.2.54.


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