title: Disease damage and low bone mineral density: an analysis of women with systemic lupus erythematosus ever and never receiving corticosteroids.
abstract: OBJECTIVE
  To evaluate the relationship between disease damage and bone mineral density (BMD) in women with systemic lupus erythematosus (SLE).
  
  
  METHODS
  A cross-sectional study was conducted among 307 women with SLE. Patients attended a single clinic visit that included an interview, physical examination, laboratory testing and BMD measurements (hip and/or lumbar spine). Women were stratified by the Systemic Lupus International Collaborating Clinics/American College of Rheumatology cumulative disease damage index (SDI) > or =1 (Damage) vs SDI=0 (No Damage), and prior use of corticosteroids (CS), yielding four groups: (1) Damage/CS(+) (n=138), (2) Damage/CS(-) (n=23), (3) no Damage/CS(-) (n=100), and (4) no Damage/CS(-) (n=46).
  
  
  RESULTS
  Mean age at SLE diagnosis was 32.7 +/- 11.8 yr, 24.4% were African American, 65.0% were premenopausal, and mean SDI +/- S.D. was 1.3 +/- 1.8. In the unadjusted and adjusted models controlling for significant univariate risk factors for osteoporosis, the reference group (Group 1) had significantly lower mean BMD T-scores at the hip and lumbar spine than groups having no disease damage (Groups 3 and 4) independent of CS use status. Similar hip and lumbar spine mean BMD T-scores were observed in women with disease damage with and without CS exposure (Groups 1 and 2).
  
  
  CONCLUSIONS
  Women with SLE having disease damage and no CS use had BMD T-scores at the hip and lumbar spine similar to those of women with disease damage and prior CS use. These findings suggest an association between disease damage and lower BMD T-scores in women with SLE.
authors.affiliation: Division of Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA. c-lee17@northwestern.edu
authors.forename: C
authors.initials: C
authors.lastname: Lee
authors.forename: O
authors.initials: O
authors.lastname: Almagor
authors.forename: D D
authors.initials: DD
authors.lastname: Dunlop
authors.forename: S
authors.initials: S
authors.lastname: Manzi
authors.forename: S
authors.initials: S
authors.lastname: Spies
authors.forename: A B
authors.initials: AB
authors.lastname: Chadha
authors.forename: R
authors.initials: R
authors.lastname: Ramsey-Goldman
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D015519:Bone Density / Q000502:physiology*; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D008159:Lumbar Vertebrae; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D008593:Menopause; D010024:Osteoporosis / Q000209:etiology / Q000503:physiopathology; D010384:Pelvic Bones
chemical_list: D000305:Adrenal Cortex Hormones