Longitudinal analysis of bone mineral density in pre-menopausal female systemic lupus erythematosus patients: deleterious role of glucocorticoid therapy at the lumbar spine.
OBJECTIVE
To evaluate whether bone loss occurs over time in pre-menopausal systemic lupus erythematosus (SLE) patients.


METHODS
We performed a longitudinal bone mineral density (BMD) analysis in a group of 35 pre-menopausal female SLE patients. Lumbar spine and hip (total and sub-regions) BMDs were measured twice 21 +/- 11 (mean +/- S.D.) months apart by dual-energy X-ray absorptiometry.


RESULTS
In the whole cohort of SLE patients, significant bone loss was observed at the lumbar spine (-1.22%/yr) but not at the total hip. Further analyses indicated that lumbar spine bone loss (-2.12%/yr) occurred exclusively in the subgroup of patients who had taken a mean prednisolone daily dose >7.5 mg between the two BMD measurements. Moreover, bone loss was more important in patients who had previously received a cumulative prednisolone dose </=5 g by the time of their first BMD evaluation.


CONCLUSIONS
These results, by demonstrating a loss of lumbar spine bone over time in pre-menopausal SLE patients given glucocorticoid (GC) therapy, strongly support the use of preventive treatment to minimize GC-induced osteoporosis in pre-menopausal female SLE patients given prednisolone daily doses >7.5 mg.
Jardinet
D
D
Rheumatology Department, Cliniques Universitaires Saint-Luc, Université catholique de Louvain, Bruxelles, Belgium.
Lefèbvre
C
C
Depresseux
G
G
Lambert
M
M
Devogelaer
J P
JP
Houssiau
F A
FA
D000328:Adult; D015519:Bone Density / Q000187:drug effects*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy*; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D017697:Premenopause
D011239:Prednisolone