Bone microarchitecture assessment by high-resolution peripheral quantitative computed tomography in patients with systemic lupus erythematosus taking corticosteroids.
OBJECTIVE
We assessed the relationship between vertebral fracture and bone microarchitecture in patients with systemic lupus erythematosus (SLE) on chronic corticosteroid therapy using high-resolution peripheral quantitative computed tomography (HR-pQCT).


METHODS
Fifty-nine Chinese women with SLE taking corticosteroid were selected to participate in a cross-sectional study. Vertebral fracture was confirmed semiquantitatively by lateral radiographs of the thoracic and lumbar spine. Density and microarchitecture at the distal radius were measured with HR-pQCT. Areal bone mineral density (aBMD) at hip and lumbar spine was measured by dual-energy X-ray absorptiometry (DEXA).


RESULTS
Twelve patients had vertebral fractures. The aBMD of spine or hip did not differ between those with and without vertebral fractures. Measures by HR-pQCT revealed that patients with vertebral fractures had significantly lower level of average bone density (p = 0.007), cortical bone density (p = 0.029), trabecular bone density (p = 0.024), trabecular bone volume to tissue volume (p = 0.023), and trabecular thickness (p = 0.011) than those without vertebral fractures. Independent explanatory variables associated with higher risk of vertebral fractures were older age (p = 0.013) and lower average cortical bone density (p = 0.029).


CONCLUSIONS
Vertebral fracture in patients with SLE on chronic corticosteroid treatment was associated with alterations of bone density and microarchitectures measured by HR-pQCT and DEXA. However, alterations were more pronounced in measurements by HR-pQCT. Low cortical bone density and old age were significant predictors of vertebral fracture risk.
Li
Edmund K
EK
Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong. edmundli@cuhk.edu.hk
Zhu
Tracy Y
TY
Tam
Lai-Shan
LS
Hung
Vivian W
VW
Griffith
James F
JF
Li
Tena K
TK
Li
Martin
M
Wong
Kong Chiu
KC
Leung
Ping Chung
PC
Kwok
Anthony W
AW
Qin
Ling
L
D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D000328:Adult; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects / Q000648:ultrastructure; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced; D016103:Spinal Fractures / Q000000981:diagnostic imaging*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
D000305:Adrenal Cortex Hormones