Prevalence of reduced bone mineral density in systemic lupus erythematosus and the role of steroids.
OBJECTIVE
To determine the prevalence of reduced bone mineral density (BMD) in a large female cohort of systemic lupus erythematosus (SLE) and to determine the role of steroids and disease related variables.


METHODS
All females with SLE managed by rheumatologists affiliated with a single center were invited to undergo BMD measurement of the lumbar spine and left femoral neck by dual energy X-ray absorptiometry (DEXA), standardized examination, and medical record review.


RESULTS
Ninety-seven females with a mean (SD) age of 44.2 (14.9) years were studied. Low bone mass [defined as BMD > 1 standard deviation (SD) below young adult mean] was present in 44.3 and 42.1% at the lumbar spine and femoral neck, respectively. Osteoporosis (defined as BMD > 2.5 SD below young adult mean) was present in 13.4 and 6.3% at the lumbar spine and femoral neck, respectively. Steroid usage showed a strong inverse relationship with BMD in the lumbar spine, but a less strong relationship in the femoral neck.


CONCLUSIONS
The findings of high prevalence of reduced BMD and association with steroid therapy have important implications for the routine management of SLE.
Kipen
Y
Y
Monash Medical Centre Rheumatology and Clinical Nutrition, Clayton, Australia.
Buchbinder
R
R
Forbes
A
A
Strauss
B
B
Littlejohn
G
G
Morand
E
E
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D015331:Cohort Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000187:drug effects; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000187:drug effects; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008875:Middle Aged; D013256:Steroids / Q000009:adverse effects* / Q000627:therapeutic use
D013256:Steroids