Association of osteoporosis and cardiovascular disease in women with systemic lupus erythematosus.
OBJECTIVE
Young women with lupus are at increased risk for premature osteoporosis and cardiovascular disease. Experimental evidence suggests that inflammation and immune-mediated mechanisms, key factors in the pathogenesis of lupus, play a role in osteogenesis and atherogenesis. This study investigated whether bone mineral density (BMD) was associated with the carotid plaque index, intima media thickness (IMT), or coronary artery calcium score in lupus patients.


METHODS
In this pilot study, 65 women with lupus underwent carotid B-mode ultrasound to measure the carotid plaque index and IMT, and dual x-ray absorptiometry to measure BMD at the lumbar spine and hip. As part of a feasibility study, 13 of these 65 patients also underwent electron-beam computed tomography to assess coronary artery calcification.


RESULTS
The carotid plaque index was higher (1.00, 1.00, and 0.38, respectively) in the patients in the lowest and middle tertiles of hip BMD when compared with patients in the highest tertile of hip BMD. The correlation coefficient between the coronary artery calcium score and lumbar spine BMD was -0.57 (P = 0.04), and between the coronary artery calcium score and hip BMD was -0.55 (P = 0.05).


CONCLUSIONS
These results demonstrate an association between decreased BMD and both an increased carotid plaque index and presence of coronary artery calcification in a small cohort of young women with lupus.
Ramsey-Goldman
R
R
Northwestern University Medical School, Chicago, Illinois, USA.
Manzi
S
S
D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D008875:Middle Aged; D010024:Osteoporosis / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D010865:Pilot Projects