Disease damage and low bone mineral density: an analysis of women with systemic lupus erythematosus ever and never receiving corticosteroids.
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.
Lee
C
C
Division of Rheumatology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA. c-lee17@northwestern.edu
Almagor
O
O
Dunlop
D D
DD
Manzi
S
S
Spies
S
S
Chadha
A B
AB
Ramsey-Goldman
R
R
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
D000305:Adrenal Cortex Hormones